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

Nicole Marie Johnson, PA-C

Individual provider Physician Assistant · NPI 1053952499

Nicole Marie Johnson, PA-C is a Physician Assistant in Winter Garden, Florida. Graduated from Duke University School of Medicine in 2019, 7 years ago. Practices with Adventhealth Primary Care Network Inc, a 410-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida and Texas.

Years since qualifying
7
Trained at
Duke University School of Medicine
Licensed in
FL, TX
In the registry since
2019
Specialties on file
2
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

2200 Fowler Grove Blvd Ste 140
Winter Garden, FL 34787-5597
Phone: (407) 614-0528
Fax: (407) 614-0529
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7630 N Beach St Ste 140, Fort Worth, TX 76137-3016 — (817) 281-2977

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9116795 (FL)
Physician Assistant Taxonomy 363A00000X (TX)

Record details

NPI number1053952499
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 7, 2019
Last updated in NPPESFebruary 13, 2023
Certification dateFebruary 13, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolDUKE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Adventhealth Primary Care Network Inc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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