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

Keelie Johnston, PA-C

Individual provider Physician Assistant · NPI 1386344471

Keelie Johnston, PA-C is a Physician Assistant in Tyler, Texas. Qualified in 2021, 5 years ago. Practices with Epiphany Dermatology PA, a 107-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
5
Licensed in
TX
In the registry since
2023
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

1038 S Fleishel Ave
Tyler, TX 75701-2044
Phone: (903) 593-9474
Fax: (903) 593-9477
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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 PA16494 (TX)

Record details

NPI number1386344471
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 7, 2023
Last updated in NPPESOctober 26, 2023
Certification dateOctober 26, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Epiphany Dermatology Pa — 107 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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