Individual provider Active NPI

Courtney Johnson

  • Surgical Physician Assistant
  • Bradenton, FL
National Provider Identifier
1164946752
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
8000 Sr 64 E
Bradenton, FL 34212
Phone
(941) 792-1404
Fax
(941) 761-0712
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

8000 Sr 64 E
Bradenton, FL 34212

Mailing address

8000 Sr 64 E
Bradenton, FL 34212
Phone (941) 792-1404

Other practice location 1

11531 30th Cv E
Parrish, FL 34219-8982
Phone (941) 404-6454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171028000343 FL Practitioner - Physician Assistant 5698041192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8340 Lakewood Ranch Blvd
Suite 300
Lakewood Ranch, FL 34202-5046
Phone (941) 792-1404

Hospital & facility affiliations

  • Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299
  • HCA Florida Sarasota Doctors Hospital Hospital, Sarasota, FL, CCN 100166
  • HCA Florida Blake Hospital Hospital, Bradenton, FL, CCN 100213
  • Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedics & Sports Medicine of Southwest Florida PA CurrentSince May 1, 2019 Accepting new patients

Locations

8000 State Road 64 E
Bradenton, FL 34212
Phone 94179214043315

6015 Pointe West Blvd
Bradenton, FL 34209
Phone (941) 782-0101

6015 Pointe West Blvd
Ste 100
Bradenton, FL 34209
Phone 9417921404 ext. 3147

6202 17th Ave W
Bradenton, FL 34209

8340 Lakewood Ranch Blvd
Ste 300
Lakewood Ranch, FL 34202
Phone (941) 316-8200

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1164946752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 SR 64 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34212",
            "telephone_number": "941-792-1404",
            "fax_number": "941-761-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 SR 64 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34212",
            "telephone_number": "941-792-1404",
            "fax_number": "941-761-0712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11531 30th Cv E",
            "address_purpose": "LOCATION",
            "city": "Parrish",
            "state": "FL",
            "postal_code": "342198982",
            "country_code": "US",
            "telephone_number": "941-404-6454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.