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

Michael Olton Johnson, PA

Individual provider Physician Assistant · NPI 1003313727

Michael Olton Johnson, PA is a Physician Assistant in Lawrenceville, Georgia. Qualified in 2020, 6 years ago. Practices with North Shore Lij Urgent Care PC, a 395-clinician group and accepts Medicare assignment. Licensed in Georgia and New York.

Years since qualifying
6
Licensed in
GA, NY
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

377 W Pike St # A3-2
Lawrenceville, GA 30046-4881
Phone: (470) 461-7031
Fax: (770) 502-6820
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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 11074 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 021943 (NY)

Record details

NPI number1003313727
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 9, 2018
Last updated in NPPESMay 9, 2023
Certification dateMay 9, 2023
Mailing address377 W Pike St # A3-2, Lawrenceville, GA 30046-4881

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice North Shore Lij Urgent Care Pc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations14 on file with Medicare

Other providers in Lawrenceville