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ETHAN JOHNSON
NPI 1619827227
Physician Assistant in Springfield, MO

Active since February 02, 2026PECOS Enrolled
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804(417) 496-0724 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN JOHNSON (NPI 1619827227) is an individual physician assistant in Springfield, Missouri and active in the NPI registry since February 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1619827227
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameETHAN JOHNSON
Location Address1235 E CHEROKEE STSpringfield, MO 65804-2203
Mailing Address1123 E Meadowlark StSpringfield, MO 65810-2961
Phone(417) 496-0724
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 2, 2026
NPPES CertifiedFebruary 2, 2026
✔ NPI 1619827227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
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.
1235 E CHEROKEE ST, Springfield, MO 65804
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608359674
PECOS Enrollment IDI20260309002873
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. SUJAN POUDEL M.D.
Internal Medicine
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 820-2600
JANEL M OCHSE MD
Emergency Medicine
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 820-2000
DR. DAWN E ZABLOCKI MD
Anesthesiology
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 820-2829
OLIVIA M. KILBURN CRNA
Nurse Anesthetist, Certified Registered
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 820-2829
VIRGINIA MCLAUGHLIN SLP
Speech-Language Pathologist
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 576-3741
MARGARET BROWN MONTGOMERY APRN
Nurse Practitioner (Gerontology)
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 820-6569
DEVIN B MOORE PA-C
Physician Assistant
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 820-5400
JACQUELYN B MARSHALL CRNA
Nurse Anesthetist, Certified Registered
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804
Greene County (417) 820-2829

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Johnson's NPI number?

The NPI number for Ethan Johnson is 1619827227. It was assigned to this individual provider in the NPPES registry on February 2, 2026.

Where is Ethan Johnson located?

Ethan Johnson practices at 1235 E Cherokee St, Springfield, MO 65804. The listed phone number is (417) 496-0724.

What is Ethan Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ethan Johnson enrolled in Medicare?

Yes. Ethan Johnson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Johnson was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.