Mrs Kelly Jackson Johnson, PA-C in Herrin, IL - Medicare Physician Assistant

Mrs Kelly Jackson Johnson, PA-C is a medicare enrolled "Physician Assistant" in Herrin, Illinois. Her current practice location is 510 Lincoln Dr, Herrin, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 997-6800.

Mrs Kelly Jackson Johnson is licensed to practice in Kentucky (license number PA1637) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235412982.

Contact Information

	Mrs Kelly Jackson Johnson, PA-C
	510 Lincoln Dr, Herrin, IL 62948-6334
	(618) 997-6800
	(618) 997-1187

Map and Direction

Provider's Profile

Full Name	Mrs Kelly Jackson Johnson
Gender	Female
Speciality	Physician Assistant
Location	510 Lincoln Dr, Herrin, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235412982
Provider Enumeration Date: 09/20/2011
Last Update Date: 02/23/2017

Medicare PECOS Information:

PECOS PAC ID: 5496927675
Enrollment ID: I20111012000368

Medical Identifiers

Medical identifiers for Mrs Kelly Jackson Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235412982	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	PA1637 (Kentucky)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kelly Jackson Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Kelly Jackson Johnson, PA-C 4787 Alben Barkley Dr, Suite 103, Paducah, KY 42001-6789 Ph: (270) 442-9461	Mrs Kelly Jackson Johnson, PA-C 510 Lincoln Dr, Herrin, IL 62948-6334 Ph: (618) 997-6800

Reviews and Comments

Physician Assistant Nurses in Herrin, IL

Mr. Leon Gauthier, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 220 N Park Ave, Suite 2, Herrin, IL 62948 Phone: 618-942-3344 Fax: 618-942-5045
Mr. John W Nugent, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 510 Lincoln Drive, Southern Orthopedic Associates Sc, Herrin, IL 62948 Phone: 618-997-6800 Fax: 618-998-9124
Mr. Hollis Johnson Clark Jr., P.A.-C. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 510 Lincoln Dr, Herrin, IL 62948 Phone: 618-997-6800 Fax: 618-997-1187
Mr. Kevin L Rainey, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 510 Lincoln Drive, Southern Orthopedic Associates Sc, Herrin, IL 62948 Phone: 618-997-6800 Fax: 618-998-9124
Mrs. Dena L Mccormick, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 201 S 14th St, Herrin, IL 62948 Phone: 618-942-2171 Fax: 618-988-6186
Gretchen B Mason, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 510 Lincoln Dr, Herrin, IL 62948 Phone: 618-997-6800 Fax: 618-998-9124

Mrs Kelly Jackson Johnson, PA-C - Medicare Physician Assistant in Herrin, IL