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

Shane Reed Johnson, PA

Individual provider Surgical Physician Assistant · NPI 1275512543

Shane Reed Johnson, PA is a Physician Assistant in Nampa, Idaho. Qualified in 1999, 27 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
27
Licensed in
ID
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

215 E Hawaii Ave
Nampa, ID 83686-6011
Phone: (208) 463-3234
Fax: (208) 463-3044
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA293 (ID)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA293 (ID)

Record details

NPI number1275512543
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 13, 2006
Last updated in NPPESDecember 18, 2009

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Nampa