MS. NICOLE A JOHNSON (NPI# 1033250576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033250576 |
| Entity Type | Individual |
| Full Name | MS. NICOLE A JOHNSON |
| Credential | PA-C |
| Practice Address |
8305 Express Drive Suite C Marion IL 62959 |
| Mailing Address |
Po Box 1433 Murphysboro IL 62966 |
| Practice Telephone | 6189930086 |
| Practice Fax Number | 6189930088 |
| Mailing Telephone | (618) 993-0086 |
| Mailing Fax Number | 6189930088 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2017-08-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085-002903 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
036-087287 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PA LICENSE NUMBER | 085-002903 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188991 | Nicole Lynn Johnson | Occupational Therapist | 2616 Overlake Ave, Orlando, FL 32806-7353 | 2020-06-11 |
| 1861015893 | Nicole Johnson | Registered Nurse | 5794 193rd St W, Farmington, MN 55024-9579 | 2020-05-26 |
| 1255969705 | Nicole Rochshel Johnson | Home Health Aide | 4045 Regina Coeli Ct, Marrero, LA 70072-6354 | 2020-03-31 |
| 1942859038 | Nicole Johnson | Developmental Therapist | 7355 13th Ave Nw, Seattle, WA 98117-5306 | 2019-09-10 |
| 1053974360 | Nicole Johnson | Student in an Organized Health Care Education/Training Program | 28741 Appletree, Mission Viejo, CA 92692-1088 | 2019-04-22 |
| 1750868212 | Nicole Marie Johnson | Psychologist | 200 E Travelers Trl Ste 205, Burnsville, MN 55337-4191 | 2018-07-26 |
| 1295228310 | Nicole Marie Johnson | Technician | 2807 Douglass Pl Se, Washington, DC 20020-4420 | 2018-06-13 |
| 1922512078 | Nicole Johnson | Occupational Therapy Assistant | 1498 Port Malabar Blvd Ne, Palm Bay, FL 32905-5240 | 2017-11-28 |
| 1083133490 | Nicole Rebecca Liu Johnson | Psychologist | 20826 2nd Ave W, Lynnwood, WA 98036-7256 | 2017-09-18 |
| 1871010967 | Nicole Lynne Johnson | Counselor | 800 Gallia Street Suite 600, Portsmouth, OH 45662 | 2017-08-29 |
| Street Address |
8305 EXPRESS DRIVE SUITE C |
| City | MARION |
| State | IL |
| Zip Code | 62959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336755297 | Taylor Jones | Physician Assistant | 583 Fowler St, Marion, VA 24354-2203 | 2020-09-16 |
| 1891316212 | Amanda Roye | Physician Assistant | 1812 Colonial Dr, Marion, IL 62959-6459 | 2020-04-27 |
| 1932646205 | Courtney Abrams | Physician Assistant | 472 Rankin Dr., Marion, NC 28752 | 2017-01-25 |
| 1982152401 | Katryna Horton | Physician Assistant | 115 Allen Cv, Marion, AR 72364-8001 | 2016-09-13 |
| 1942592324 | Jennifer Nicole Smith | Physician Assistant | 5623 Us 221 S, Marion, NC 28752-7028 | 2011-05-04 |
| 1174832893 | Amanda Rae Reaney | Physician Assistant | 3204 Cherokee Dr, Marion, IL 62959-5255 | 2010-09-29 |
| 1528186947 | Sandra Grazulewicz | Physician Assistant | 130 Finley Gayle Dr, Marion, VA 24354-3141 | 2007-03-26 |
| 1346377199 | Steven Lee Martinez | Physician Assistant | 3003 Civic Circle Blvd Ste 200, Marion, IL 62959-5259 | 2007-02-28 |
| 1235215633 | Jennifer L Alexander | Physician Assistant | 3106 Outer Drive, Marion, IL 62959 | 2006-10-27 |
| 1083798276 | Mitchell S Swieca | Physician Assistant | 3331 West Deyoung St, Suite 105, Marion, IL 62959 | 2006-10-24 |
| Find all providers in MARION | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.