Nicholas Bradford Johnson, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

M-14721 Issued in ID

Practice address

3200 Channing Way Ste 206
Idaho Falls, ID 83404-7546

Phone

(208) 529-2230

Fax

(208) 453-6142

NPI assigned

Jul 1, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive SurgeryAlso: General Surgery

Education

St. Louis College of Physicians and Surgeons, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Steele Lake Specialty PLLCGroup PAC ID 1153774567, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brio Idaho Healthcare Home health agency, Idaho Falls, ID, CCN 137128
• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Steele Lake Specialty PLLC

  • Surgery Physician
  • Idaho Falls, ID
  • NPI 1215716998
  Medicare reassignment Care Compare group NPD

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

• Brio Idaho Home Health LLC

  • Home Health Agency
  • Idaho Falls, ID
  • NPI 1285189548
  Care Compare affiliation
• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1578850210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE A206",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047586",
            "telephone_number": "208-529-2230",
            "fax_number": "208-561-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE 206",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-529-2230",
            "fax_number": "208-453-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICHOLAS",
        "middle_name": "BRADFORD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "ID",
            "license": "M-14721",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "ID",
            "license": "M-14721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly W. Johnson, LCPC
• Kylee Dee Johnson, APRN, CNM, WHNP
• Mackenzie Johnson
• Myria Johnson
• Myrriah Johnson
• Olivia Anne Johnson, RBT
• Samuel Pennington Johnson, NP
• Shannon Kay Johnson, LMSW
• Shelby Johnson
• Teresa Kay Johnson, MD

• Plastic Surgery Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Plastic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.