Jessica Johnson

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.0006363 Issued in CO

Practice address

421 S Tejon St Ste 250
Colorado Springs, CO 80903-2139

Phone

(719) 623-3068

NPI assigned

Sep 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2026 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1124633904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S TEJON ST STE 250",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032139",
            "telephone_number": "719-623-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S TEJON ST STE 250",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032139",
            "telephone_number": "719-623-3068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4190 E Woodmen Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809208075",
            "country_code": "US",
            "telephone_number": "719-632-4455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0006363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson@peakmed.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "421 S Tejon St Ste 250",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809032139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Denise Johnson
• Jeanne Ann Johnson, LPN
• Jeanne May Johnson, PT
• Jenny Lynn Johnson, MA, LPC, LAC
• Jeremy Duane Johnson, PA-C
• Jessica Johnson
• Judy L Johnson, RDH
• Julia Crystal Johnson, DC
• Julianne Johnson, BCABA
• Julie Jackson Johnson, PA-C

• Medical Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.