Individual provider Active NPI

Arthur Allen Johnson, PA-C

  • Physician Assistant
  • Grass Valley, CA
National Provider Identifier
1104880830
Registry record updated Oct 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64260 Issued in CA
Practice address
844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone
(530) 274-9762
Fax
(530) 273-4573
NPI assigned
Apr 12, 2006
Last updated
Oct 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA64260 CA
Physician Assistant 363A00000X PA64260 CA Primary

Addresses

Primary practice location

844 Old Tunnel Rd
Grass Valley, CA 95945-8524

Mailing address

20926 N Lauren Rd
Maricopa, AZ 85138-6881
Phone (702) 350-5599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NV, UT3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050630000897 AZ Practitioner - Physician Assistant 6507801735 Reassigns benefits to 1 organization
I20070227000494 NV Practitioner - Physician Assistant 6507801735 Reassigns benefits to 2 organizations
I20230307000490 UT Practitioner - Physician Assistant 6507801735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3189AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt General Hospital CurrentSince Feb 12, 2020 Accepting new patients
Humboldt General Hospital CurrentSince Feb 12, 2020 Accepting new patients
Texan Urgent Care PLLC Past Accepting new patients
Douglas J Seip MD LTD Past Accepting new patients

Locations

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

Interoperability endpoints

  • Direct secure messaging: arthur.johnson.p1@direct.toiyabe.nextgenshare.com
  • Direct secure messaging: arthur.johnson@gandkmed.directbygreenway.com
  • Direct secure messaging: arthur.johnson@wsmc1.eclinicaldirectplus.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792972800000",
    "number": "1104880830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20926 N LAUREN RD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851386881",
            "telephone_number": "702-350-5599",
            "fax_number": "480-605-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 OLD TUNNEL RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959458524",
            "telephone_number": "530-274-9762",
            "fax_number": "530-273-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ARTHUR",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2026-10-26",
        "certification_date": "2026-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA64260",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.