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

Mr. Parker Brandt Johnson, PA-C

Individual provider Physician Assistant · NPI 1710578117

Mr. Parker Brandt Johnson, PA-C is a Physician Assistant in Bloomington, Illinois. Graduated from University of Nebraska College of Medicine in 2020, 6 years ago. Practices with Carle West Physician Group Inc, a 285-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
6
Trained at
University of Nebraska College of Medicine
Licensed in
IL
In the registry since
2021
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

1111 Trinity Ln Ste 111
Bloomington, IL 61704-8112
Phone: (309) 663-6461
Fax: (309) 663-4529
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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 085008197 (IL)

Record details

NPI number1710578117
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 28, 2021
Last updated in NPPESDecember 15, 2025
Certification dateDecember 15, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Carle West Physician Group Inc — 285 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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