Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Evan Johnson, PA-C

Individual provider Physician Assistant · NPI 1912637042

Evan Johnson, PA-C is a Physician Assistant in Burley, Idaho. Qualified in 2023, 3 years ago. Practices with Physicians Immediate Care of Twin Falls PA, a 9-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
3
Licensed in
ID
In the registry since
2022
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

1252 Bennett Ave Ste B
Burley, ID 83318-2664
Phone: (208) 647-0656
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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 PA-2622 (ID)

Record details

NPI number1912637042
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 13, 2022
Last updated in NPPESNovember 4, 2023
Certification dateNovember 4, 2023
Mailing address1252 Bennett Ave Ste B, Burley, ID 83318-2664

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Physicians Immediate Care Of Twin Falls Pa — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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