IndividualActive
Gregory Johnson, M.D.
NPI 1417922857 · Geriatric Medicine (Family Medicine) Physician · Peoria, IL
Provider details
- NPI number
- 1417922857
- Entity type
- Individual
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 036115494 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
900 Main St
Suite 100
Peoria, IL 61602-1005
Phone: (309) 672-4908
Fax: (309) 672-4272
Street-level locationGet directions
Mailing address
900 Main St
Peoria, IL 61602-1005
Registry dates
- Enumerated
- 2006-02-21
- Last updated
- 2013-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.