Courtney Johnson
Physician Assistant, Surgical in Bradenton, FL. Individual provider (NPI-1).
Details
- NPI
- 1164946752
- Entity type
- Individual (NPI-1)
- Name
- Courtney Johnson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 26, 2017
- Certification date
- May 27, 2026
- Last updated
- May 27, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
Practice location
8000 Sr 64 EBradenton, FL 34212
Phone 941-792-1404 · Fax 941-761-0712
Mailing address
8000 Sr 64 EBradenton, FL 34212
Phone 941-792-1404 · Fax 941-761-0712
Other practice locations
Parrish, FL 34219-8982
Phone 941-404-6454
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 13 Surgical Physician Assistant providers in Bradenton · All 5,544 providers in Bradenton
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