| Melissa Kay Johnson, NP-C | |
|
5409 N Knoxville Ave, Peoria, IL 61614-5069 | |
| (309) 691-1069 | |
| Not Available |
| Full Name | Melissa Kay Johnson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 10 Years |
| Location | 5409 N Knoxville Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942744495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | A130336 (Iowa) | Primary |
| 363LF0000X | Nurse Practitioner - Family | F1216074 (Illinois) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Proctor Hospital | Peoria, IL | Hospital |
| Pekin Memorial Hospital | Pekin, IL | Hospital |
| Mercyone Clinton Medical Center | Clinton, IA | Hospital |
| Genesis Hlth System Dba Genesis Mdl Ctr-illini | Silvis, IL | Hospital |
| Trinity - Bettendorf | Bettendorf, IA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Vituity-iowa Pllc | 3476909409 | 31 |
| Iowa Emergency Services Llc | 3678837580 | 8 |
| Trinity Medical Center | 2264337518 | 99 |
| Trinity Medical Center | 2264337518 | 99 |
| Genesis Health System | 6103829338 | 268 |
| Entity Name | Iowa Emergency Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821591454 PECOS PAC ID: 3678837580 Enrollment ID: O20180501000864 |
| Entity Name | Vituity-iowa Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437932928 PECOS PAC ID: 3476909409 Enrollment ID: O20231027001912 |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Kay Johnson, NP-C 801 Illini Drive, Echo Qc, Ltd, Silvis, IL 61282-1804 Ph: (309) 281-4074 | Melissa Kay Johnson, NP-C 5409 N Knoxville Ave, Peoria, IL 61614-5069 Ph: (309) 691-1069 |
Mr. Ryan Eugene Parnham, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Suite 108, Peoria, IL 61537 Phone: 309-624-8818 | |
Faye Yetton, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2015 W Austin Dr, Peoria, IL 61614 Phone: 309-256-0632 | |
Linda Schmidgall, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 Ne Glen Oak Ave, Suite 200, Peoria, IL 61603 Phone: 309-624-5100 Fax: 309-624-5569 | |
Sandra L. Peach, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 Ne Glen Oak Ave, Peoria, IL 61603 Phone: 309-655-2343 Fax: 309-655-3948 | |
Courtney Harley, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 Phone: 309-676-8123 Fax: 309-676-8455 | |
Roxanne R Mclaughlin, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6501 N Sheridan Rd, Peoria, IL 61614 Phone: 309-308-5050 | |
Suzanne D Tietjen, BSN, NNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2974 |