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KELLY JOHANSON APRN
NPI 1881377034
Nurse Practitioner - Family in Saint Louis, MO

Active since August 14, 2023PECOS EnrolledAccepts Medicare Assignment
650 MARYVILLE UNIVERSITY DR, SAINT LOUIS, MO 63141(800) 627-9855 Get Directions Write a Review

NPPES record last updated: August 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Johanson Aprn NPPES

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

KELLY JOHANSON APRN (NPI 1881377034) is an individual family provider in Saint Louis, Missouri, licensed in Illinois (209.027053) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1881377034
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKELLY JOHANSONCredential: APRN
Location Address650 MARYVILLE UNIVERSITY DRSaint Louis, MO 63141-5849
Mailing Address1304 Franklin AveNormal, IL 61761-3558
Phone(800) 627-9855
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateAugust 14, 2023
NPPES CertifiedAugust 13, 2023
✔ NPI 1881377034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.027053
650 MARYVILLE UNIVERSITY DR, Saint Louis, MO 63141
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Johanson Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597296657
PECOS Enrollment IDI20241001001880
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63141 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

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

HALEY MCCROSSIN
Student in an Organized Health Care Education/Training Program
650 MARYVILLE UNIVERSITY DR
SAINT LOUIS, MO 63141
St. Louis County (800) 627-9855
MARIE M WEBB FNP
Nurse Practitioner (Family)
650 MARYVILLE UNIVERSITY DR
CREVE COEUR, MO 63141
St. Louis County (800) 627-9855
ALICIA PASTORE
Nurse Practitioner (Psychiatric/Mental Health)
650 MARYVILLE UNIVERSITY DR
SAINT LOUIS, MO 63141
St. Louis County (800) 627-9855
KELLY LYNN STEINMETZ FNP
Nurse Practitioner (Family)
650 MARYVILLE UNIVERSITY DR
SAINT LOUIS, MO 63141
St. Louis County (800) 627-9855
MS. RACHEL PHILLIPS BARNIDGE NURSE PRACTRIONER
Nurse Practitioner (Family)
650 MARYVILLE UNIVERSITY DR
SAINT LOUIS, MO 63141
St. Louis County (314) 529-9520
MRS. TAYLOR ROSENHAGEN CPNP-PC
Nurse Practitioner (Pediatrics)
650 MARYVILLE UNIVERSITY DR
SAINT LOUIS, MO 63141
St. Louis County (724) 963-5450
KATRINA MAE HAIGH NP, CPNP-PC
Nurse Practitioner (Pediatrics)
650 MARYVILLE UNIVERSITY DR
SAINT LOUIS, MO 63141
St. Louis County (800) 627-9855
TRISTEN LEE DONNER FNP
Nurse Practitioner
650 MARYVILLE UNIVERSITY DR
SAINT LOUIS, MO 63141
St. Louis County (314) 529-9300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Johanson's NPI number?

The NPI number for Kelly Johanson is 1881377034. It was assigned to this individual provider in the NPPES registry on August 14, 2023.

Where is Kelly Johanson located?

Kelly Johanson practices at 650 Maryville University Dr, Saint Louis, MO 63141. The listed phone number is (800) 627-9855.

What is Kelly Johanson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kelly Johanson enrolled in Medicare?

Yes. Kelly Johanson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kelly Johanson affiliated with any hospitals?

According to CMS data, Kelly Johanson is affiliated with Saint Francis Medical Center.

When was this NPI record last updated?

The NPPES record for Kelly Johanson was last updated on August 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.