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

Ethan Johnson

Individual provider Physician Assistant · NPI 1619827227

Ethan Johnson is a Physician Assistant in Springfield, Missouri. Qualified in 2025, 1 year ago. Practices with Mercy Clinic Springfield Communities, a 1,126-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2026
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Practice location Address checks out

1235 E Cherokee St
Springfield, MO 65804-2203
Phone: (417) 496-0724
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1619827227
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 2, 2026
Last updated in NPPESFebruary 2, 2026
Certification dateFebruary 2, 2026
Mailing address1123 E Meadowlark St, Springfield, MO 65810-2961

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)
Group practice Mercy Clinic Springfield Communities — 1126 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Springfield