Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

David E Johnson, ANP

Individual provider Nurse Practitioner · NPI 1477742047

David E Johnson, ANP is a Nurse Practitioner in Maryville, Illinois. Qualified in 2000, 26 years ago. Practices with Anderson Medical Group LLC, a 139-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
26
Licensed in
IL
In the registry since
2007
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Practice location Address checks out

6812 State Route 162 Ste 21
Maryville, IL 62062-8565
Phone: (618) 288-5566
Fax: (618) 288-4005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2090 Uadalabene Drive, Maryville, IL 62062 — (618) 288-5430

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209-004434 (IL)

Record details

NPI number1477742047
Entity typeIndividual (Type 1)
GenderMale
Credentials ANP
Sole proprietorNo
NPI enumeratedOctober 19, 2007
Last updated in NPPESAugust 28, 2024
Certification dateAugust 28, 2024
Mailing address6810 State Route 162 Box 215, Maryville, IL 62062-8501

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Anderson Medical Group Llc — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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