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

Kaitlyn Johnson, PA-C

Individual provider Physician Assistant · NPI 1780484477

Kaitlyn Johnson, PA-C is a Physician Assistant in Jacksonville, Florida. Qualified in 2025, 1 year ago. Practices with Coastal Dermatology PA, a 4-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025
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

2804 Saint Johns Bluff Rd S Ste 109
Jacksonville, FL 32246-3777
Phone: (772) 404-1220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 183 Landrum Ln Ste 201, Ponte Vedra Beach, FL 32082-3838 — (904) 932-0685

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9120892 (FL)

Record details

NPI number1780484477
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMarch 13, 2025
Last updated in NPPESOctober 2, 2025
Certification dateOctober 2, 2025
Mailing address2804 Saint Johns Bluff Rd S Ste 109, Jacksonville, FL 32246-3777

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 Coastal Dermatology Pa — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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