Jennifer Ann Johnson, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA.0004517 Issued in CO

Practice address

4102 Pinion Dr
US Air Force, CO 80840-2502

Phone

(719) 333-5041

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jennifer.johnson.1@4082.direct.athenahealth.com

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.

• Integral First Assist Services, LLC

  • Surgical Physician Assistant
  • Colorado Springs, CO
  • NPI 1528616091
  NPD Authorized official

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1437103702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "US AIR FORCE",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 E Woodmen Rd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809232601",
            "country_code": "US",
            "telephone_number": "719-571-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2446 Research Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809201087",
            "country_code": "US",
            "telephone_number": "719-623-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0004517",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1470-023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41960600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanette Mason Bachmann, M.D.
• Brian Bruce Cameron, M.S.W.
• Evan Matthew Jones, M.D.
• Erick J Kozlowski, ATC
• Roberta Moore, FNP-C
• Jay C. Neubauer, MD, MPH
• David James Stamps, CRNA

• Surgical Physician Assistant in US Air Force, CO
• Providers in US Air Force, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.