Deactivated NPI 1104930999 Deactivated / Inactive NPI Female Practitioner

Dr. Jan Lynn Johnson , DO

Specialist • Independence, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jan Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 18, 2006

NPI Deactivation Date June 08, 2020

Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Jan Johnson, DO was a registered Specialist practicing in Independence, MO. Throughout an active medical career spanning 14 years, Dr. Johnson provided care at the practice location at 4741 S ARROWHEAD until profile deactivation on 2020-06-08.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit, urinalysis, manual test. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

4741 S Arrowhead
Suite B

Independence, MO 64055

Telephone 8167956000

Fax 8167956064

Associated Practice Facility / Clinic

🏢 Primary Care Center Of Kansas City Llc Facility NPI 1386739035

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Independence, MO

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 37.3 Yrs

Regional Practice Density

15 Specialists

Practicing in Independence, MO (503 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

49.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2020)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	155	124	$174.00	$107.19
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	51	51	$213.00	$105.71
81002 Urinalysis, manual test	18	15	$39.00	$3.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	540	356	$174.19	$103.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	303	303	$213.41	$103.49
81002 Urinalysis, manual test	124	90	$39.00	$3.41
99213 Established patient office or other outpatient visit, typically 15 minutes	124	100	$125.00	$71.18
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	27	27	$50.00	$16.20
94640 Inhalation treatment for airway obstruction or sputum production	26	24	$50.00	$17.01
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	12	11	$50.00	$15.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	732	492	$174.14	$101.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	396	396	$213.00	$101.83
81002 Urinalysis, manual test	175	142	$39.00	$3.41
99213 Established patient office or other outpatient visit, typically 15 minutes	154	136	$126.71	$69.44
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	80	78	$50.00	$16.20
94640 Inhalation treatment for airway obstruction or sputum production	43	41	$50.00	$17.27
87804 Detection test by immunoassay with direct visual observation for influenza virus	30	30	$75.00	$16.22
93000 Routine ekg using at least 12 leads including interpretation and report	14	13	$75.00	$16.05
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	13	13	$50.00	$19.27

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	308	246	$174.98	$98.50
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	279	279	$213.44	$100.23
99213 Established patient office or other outpatient visit, typically 15 minutes	245	196	$125.61	$68.70
81002 Urinalysis, manual test	107	91	$39.00	$3.43
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	61	57	$50.00	$16.11
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$228.00	$152.30
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	16	15	$50.00	$23.35

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MO D0101286

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

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

3 Associated Practitioners

Valerie Bellario , ARNP

Nurse Practitioner - Family

NPI 1104223551

Advanced Registered Nurse Practitioner

Dr. Robert Frank , DO

Internal Medicine

NPI 1457305799

Doctor of Osteopathic Medicine (D.O.)

Jennifer Grant , APRN

Nurse Practitioner - Family

NPI 1780957290

Advanced Practice Registered Nurse

Career & Practice History Timeline

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

7 Historical Events

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NPI Profile Deactivated June 08, 2020

Record deactivated on June 08, 2020

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NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 4741 S ARROWHEAD, SUITE B, INDEPENDENCE, MO 64055 (Tel: 8167956000)

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Updated Business Mailing Address July 08, 2007

Registered at 4741 S ARROWHEAD, SUITE B, INDEPENDENCE, MO 64055 (Tel: 8167956000)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JAN JOHNSON, DO

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #D0101286 in MO)

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Initial NPI Registration & Enumeration August 18, 2006

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: 1104930999

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 18, 2006

Last Update: July 08, 2007

Deactivation Date: June 08, 2020

Update or Correct Profile

Mailing Address

4741 S Arrowhead, Suite B

Independence, MO 64055

Phone: 8167956000

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.