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DAVID MICHAEL JOHNSON
NPI 1891375416
Physician Assistant - Medical in Highland, UT

Active since April 08, 2021PECOS Enrolled
11578 N BROADLEAF HOLLOW LN, HIGHLAND, UT 84003(208) 577-8820 Get Directions Write a Review

NPPES record last updated: October 22, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 22, 2021, Apr 8, 2021 (2 updates tracked since 2021).

About David Michael Johnson NPPES

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

DAVID MICHAEL JOHNSON (NPI 1891375416) is an individual medical provider in Highland, Utah, licensed in Utah (12423884-8906) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891375416
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameDAVID MICHAEL JOHNSON
Location Address11578 N BROADLEAF HOLLOW LNHighland, UT 84003-5633
Mailing Address11578 N Broadleaf Hollow LnHighland, UT 84003-5633 · (208) 577-8820
Phone(208) 577-8820
Sole ProprietorNo
Enumeration DateApril 8, 2021
Last NPPES UpdateOctober 22, 20212 updates tracked since enumeration
NPPES CertifiedOctober 4, 2021
✔ NPI 1891375416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in UT · 12423884-8906
11578 N BROADLEAF HOLLOW LN, Highland, UT 84003
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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)

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

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.

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 David Johnson's NPI number?

The NPI number for David Johnson is 1891375416. It was assigned to this individual provider in the NPPES registry on April 8, 2021.

Where is David Johnson located?

David Johnson practices at 11578 N Broadleaf Hollow Ln, Highland, UT 84003. The listed phone number is (208) 577-8820.

What is David Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is David Johnson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for David Johnson was last updated on October 22, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.