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Connor Lee Johnson , PA

Physician Assistant β€’ Provo, UT

Active NPI 1982443065 Individual Practitioner Male Practitioner
Practice location in NPPES

395 W Cougar Blvd
Provo, UT 846043311

Call 8013577081 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

395 W Cougar Blvd

Provo, UT 846043311

Telephone 8013577081
Organization at the Same NPPES Address or Phone
Ihc Health Services Inc Facility NPI 1720792583

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2025

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

Years since graduation

1 years (graduated 2025)

CMS Doctors and Clinicians data list 2025 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

May accept Medicare assignment

CMS data show this clinician may accept Medicare assignment. Clinicians who do not always accept assignment can decide case by case.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Connor Johnson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Connor Johnson as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Provo and Utah

147 active clinicians are listed under Physician Assistant with a practice address in Provo, UT (1,887 in Utah).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Provo

19% of these 147 clinicians have the CMS telehealth indicator.

76.9% of these 147 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-02-24
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES UT 14271190-1206

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

License # reported to NPPES UT 14271190-1206
Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

License # reported to NPPES CO PA.0009589
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Utah Division of Professional Licensing.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20260417001497

Enrollment State Jurisdiction

UT

PECOS Control ID

5092291005

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

24 listed
Dr. Phanindra Antharam , MD

Internal Medicine - Cardiovascular Disease

NPI 1811483381

Doctor of Medicine (M.D.)

James Arregui , PA-C

Physician Assistant

NPI 1023407848

Physician Assistant (Certified)

Dr. Nkem Aziken , MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NPI 1740625540

Doctor of Medicine (M.D.)

Krystal Bischoff , FNP

Nurse Practitioner

NPI 1386258119

Family Nurse Practitioner

Brittany Call

Nurse Practitioner

NPI 1962151183
Andrea Chavez , FNP

Nurse Practitioner - Family

NPI 1679256960

Family Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

16 Historical Events
πŸ“
Updated Practice Location February 24, 2026

Registered at 395 W COUGAR BLVD, PROVO, UT 846043311 (Tel: 8013577081)

πŸ“
Updated Business Mailing Address February 24, 2026

Registered at PO BOX 27128, SALT LAKE CITY, UT 841270128

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2026

Physician Assistant (license number reported to NPPES: UT 14271190-1206)

πŸ“
Updated Practice Location January 05, 2026

Registered at 12605 E 16TH AVE, AURORA, CO 800452545 (Tel: 7208480000)

πŸ“
Updated Business Mailing Address January 05, 2026

Registered at PO BOX 110429, AURORA, CO 800420429

πŸ‘€
Provider Name / Credentials Updated January 05, 2026

Recorded as CONNOR JOHNSON, PA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2026

Physician Assistant (license number reported to NPPES: CO PA.0009589)

πŸ“
Updated Practice Location September 29, 2025

Registered at 12505 E. 16TH AVE., AIP2, 3RD FLOOR, AURORA, CO 80045 (Tel: 3037243513)

πŸ“
Updated Business Mailing Address September 29, 2025

Registered at 12505 E. 16TH AVE., AIP2, 3RD FLOOR, AURORA, CO 80045 (Tel: 3037243513)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 29, 2025

Physician Assistant

βœ…
NPI Profile Active May 20, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 20, 2024

Registered at 8401 S CHAMBERS RD, ENGLEWOOD, CO 801123276 (Tel: 3033732008)

πŸ“
Business Mailing Address (Initial Record) May 20, 2024

Registered at 8401 S CHAMBERS RD, ENGLEWOOD, CO 801123276 (Tel: 3033732008)

πŸ‘€
Provider Name / Credentials (Initial Record) May 20, 2024

Recorded as CONNOR JOHNSON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 20, 2024

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration May 20, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1982443065
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 20, 2024
Last Update: February 24, 2026
Sole Proprietor: No

Other Physician Assistants in Provo

All Physician Assistants in Provo

Mailing Address

Po Box 27128

Salt Lake City, UT 841270128

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.