MRS. KELLY JACKSON JOHNSON PA-C
NPI 1235412982
Physician Assistant in Herrin, IL

Q: What is Kelly Johnson's NPI number?

The NPI number for Kelly Johnson is 1235412982. It was assigned to this individual provider in the NPPES registry on September 20, 2011. The provider is also known as Kelly Elizabeth Jackson.

Q: What is Kelly Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Johnson was last updated on February 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 20, 2011PECOS Enrolled

95.5/100

CMS Quality Rating

510 LINCOLN DR, HERRIN, IL 62948(618) 997-6800(618) 997-1187 Get Directions Write a Review

NPPES record last updated: February 23, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mrs. Kelly Jackson Johnson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KELLY JACKSON JOHNSON PA-C (NPI 1235412982) is an individual physician assistant in Herrin, Illinois, licensed in Kentucky (PA1637) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235412982

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. KELLY JACKSON JOHNSONCredential: PA-C

Location Address510 LINCOLN DRHerrin, IL 62948-6334

Mailing Address4787 Alben Barkley Dr, Suite 103Paducah, KY 42001-6789 · (270) 442-9461 · Fax (270) 441-0079

Phone(618) 997-6800

Fax(618) 997-1187

Sole ProprietorNo

Enumeration DateSeptember 20, 2011

Last NPPES UpdateFebruary 23, 2017

✔ NPI 1235412982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in KY · PA1637

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

510 LINCOLN DR, Herrin, IL 62948

Open in Google Maps ↗

Other Names 1

Former Name (1)Kelly Elizabeth Jackson

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kelly Jackson Johnson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

32 services32 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62948 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.5/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

89.59

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC

Clinic/Center (Ambulatory Surgical)