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

Mr. Nicholas Johnson

Individual provider Medical Physician Assistant · NPI 1881019107

Mr. Nicholas Johnson is a Physician Assistant in Saint Louis, Missouri. Qualified in 2014, 12 years ago. Practices with Missouri Baptist Medical Center, a 123-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
12
Licensed in
MO
In the registry since
2014
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Practice location Address checks out

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone: (314) 996-7033
Fax: (314) 996-5909
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2014003457 (MO)

Record details

NPI number1881019107
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 24, 2014
Last updated in NPPESJanuary 14, 2021
Certification dateJanuary 14, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Missouri Baptist Medical Center — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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