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

Nicholas Bradford Johnson, MD

Individual provider Plastic and Reconstructive Surgery Physician · NPI 1578850210

Nicholas Bradford Johnson, MD is a Plastic and Reconstructive Surgery in Idaho Falls, Idaho. Graduated from St Louis College of Physicians and Surgeons in 2010, 16 years ago. Practices with Steele Lake Specialty PLLC, a 19-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
16
Trained at
St Louis College of Physicians and Surgeons
Licensed in
ID
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3200 Channing Way Ste 206
Idaho Falls, ID 83404-7546
Phone: (208) 529-2230
Fax: (208) 453-6142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence M-14721 (ID)
Plastic and Reconstructive Surgery Physician Taxonomy 2086S0122X · Licence M-14721 (ID)

Record details

NPI number1578850210
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 1, 2011
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026

Medicare enrollment

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

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Also practisesGENERAL SURGERY
Medical schoolST. LOUIS COLLEGE OF PHYSICIANS AND SURGEONS
Graduated 2010 (16 years in practice)
Group practice Steele Lake Specialty Pllc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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