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

Connor Lee Johnson, PA

Individual provider Physician Assistant · NPI 1982443065

Connor Lee Johnson, PA is a Physician Assistant in Provo, Utah. Qualified in 2025, 1 year ago. Licensed in Colorado and Utah.

Years since qualifying
1
Licensed in
CO, UT
In the registry since
2024
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

395 W Cougar Blvd
Provo, UT 84604-3311
Phone: (801) 357-7081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14271190-1206 (UT)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 14271190-1206 (UT)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA.0009589 (CO)

Record details

NPI number1982443065
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 20, 2024
Last updated in NPPESFebruary 24, 2026
Certification dateFebruary 24, 2026
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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