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

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 NameMrs Kelly Jackson Johnson
GenderFemale
SpecialityPhysician Assistant
Location510 Lincoln Dr, Herrin, Illinois
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1235412982NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician 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 AddressPractice 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: Medicare Enrolled
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

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.