Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andrew Mark Johansson, PA-C

Individual provider Physician Assistant · NPI 1417189473

Andrew Mark Johansson, PA-C is a Physician Assistant in Newport News, Virginia. Graduated from Eastern Virginia Medical School in 2009, 17 years ago. Practices with Integrative Regional Medical Center, PC, a 9-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
17
Trained at
Eastern Virginia Medical School
Licensed in
VA
In the registry since
2009
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

730 Thimble Shoals Blvd Ste 130
Newport News, VA 23606-4562
Phone: (757) 873-1554
Fax: (757) 873-3239
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4030 George Washington Mem Hwy Ste B, Yorktown, VA 23692-2619 — (757) 873-1554

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110003089 (VA)

Record details

NPI number1417189473
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 10, 2009
Last updated in NPPESApril 14, 2025
Certification dateApril 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 2009 (17 years in practice)
Group practice Integrative Regional Medical Center, Pc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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