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

Individual provider Physician Assistant · NPI 1245913573

Stevenson Johnson, PA-C is a Physician Assistant in Orem, Utah. Qualified in 2024, 2 years ago. Practices with Sky Lakes Medical Center Inc, a 197-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
2
Licensed in
OR
In the registry since
2023
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

800 W University Pkwy
Orem, UT 84058-6703
Phone: (801) 863-7982
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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 PA221837 (OR)

Record details

NPI number1245913573
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 11, 2023
Last updated in NPPESJuly 13, 2024
Certification dateJuly 13, 2024
Mailing address2865 Daggett Ave, Klamath Falls, OR 97601-1106

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Sky Lakes Medical Center Inc — 197 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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