Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1336603109 Individual Practitioner Female Practitioner

Nicole Lee Johnson , LPN

Licensed Practical Nurse • Marion, IL

Professional Overview & Biography Verified Profile Summary

Nicole Johnson, LPN is a registered healthcare professional specializing in Licensed Practical Nurse in Marion, IL. Practice services are available at 11531 SUNDERLAND RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

11531 Sunderland Rd

Marion, IL 629598274

Telephone 6182019907

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Marion, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
55 Specialists

Practicing in Marion, IL (906 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License IL 043120707

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Taxonomy Code
164W00000X (IL)
Commercial Insurance / Payer ID Drivers License
J52563291734 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

27 Associated Practitioners
Amber Stull

Licensed Practical Nurse

NPI 1144092776
Mariann Cook , LPN

Licensed Practical Nurse

NPI 1154870608

Licensed Practical Nurse

Mitchell Baker , RN

Registered Nurse

NPI 1174344766

Registered Nurse

Shylah Heath , LPN

Licensed Practical Nurse

NPI 1184305260

Licensed Practical Nurse

Jasmine Scott

Licensed Practical Nurse

NPI 1235746892
Elena Mcmillin , LPN

Licensed Practical Nurse

NPI 1285153254

Licensed Practical Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 25, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location January 25, 2019

Registered at 11531 SUNDERLAND RD, MARION, IL 629598274 (Tel: 6182019907)

📍
Updated Business Mailing Address January 25, 2019

Registered at 4713 ELKVILLE RD, VERGENNES, IL 629941805 (Tel: 6182019907)

👤
Provider Name / Credentials Updated January 25, 2019

Recorded as NICOLE JOHNSON, LPN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 25, 2019

Licensed Practical Nurse (License #043120707 in IL)

🟢
Initial NPI Registration & Enumeration January 25, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336603109
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 25, 2019
Last Update: January 25, 2019
Sole Proprietor: Yes

Mailing Address

4713 Elkville Rd

Vergennes, IL 629941805

Phone: 6182019907

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.