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

MS. Nicole A Johnson, PA-C

Individual provider Medical Physician Assistant · NPI 1033250576

MS. Nicole A Johnson, PA-C is a Physician Assistant in Carbondale, Illinois. Graduated from University of Nebraska College of Medicine in 2011, 15 years ago. Practices with Deaconess Illinois Specialty Clinic, Inc, a 139-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
15
Trained at
University of Nebraska College of Medicine
Licensed in
IL
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

405 W Jackson St
Carbondale, IL 62901-1462
Phone: (618) 549-0721
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 201 S 14th St, Herrin, IL 62948-3631 — (618) 942-2171
  • 8305 Express Drive, Marion, IL 62959 — (618) 993-0086
  • 2 S Hospital Dr, Murphysboro, IL 62966-3333 — (618) 684-3156

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-002903 (IL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 036-087287 (IL)

Record details

NPI number1033250576
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedFebruary 9, 2007
Last updated in NPPESNovember 9, 2021
Certification dateNovember 9, 2021

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 2011 (15 years in practice)
Group practice Deaconess Illinois Specialty Clinic, Inc. — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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