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

Bryan Wayne Johnson, PA-C

Individual provider Physician Assistant · NPI 1508872763

Bryan Wayne Johnson, PA-C is a Physician Assistant in Nampa, Idaho. Graduated from University of Nebraska College of Medicine in 2006, 20 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Georgia and Idaho.

Years since qualifying
20
Trained at
University of Nebraska College of Medicine
Licensed in
GA, ID
In the registry since
2006
Specialties on file
2
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

9850 W St Lukes Dr Ste 260
Nampa, ID 83687-7912
Phone: (208) 381-6930
Fax: (208) 381-6931
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1072 N Liberty St Ste 300, Boise, ID 83704-8708 — (208) 302-2300
  • 697 Louisiana Drive, Abilene, TX 79607-4765 — (325) 696-4754

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2055 (ID)
Physician Assistant Taxonomy 363A00000X · Licence 1071708 (GA)

Record details

NPI number1508872763
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 31, 2006
Last updated in NPPESDecember 3, 2024
Certification dateDecember 3, 2024
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated 2006 (20 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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