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

Micah Johnson

Individual provider Physician Assistant · NPI 1326469248

Micah Johnson is a Physician Assistant in Pueblo, Colorado. Qualified in 2013, 13 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado.

Years since qualifying
13
Licensed in
CO
In the registry since
2013
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Practice location Address checks out

1600 N Grand Ave Ste 508
Pueblo, CO 81003-2700
Phone: (719) 595-7040
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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 0003846 (CO)

Record details

NPI number1326469248
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 19, 2013
Last updated in NPPESDecember 19, 2013
Mailing address1600 N Grand Ave, Suite 508, Pueblo, CO 81003-2700

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Pueblo