Active NPI
Carolyn J. Johnson-Dragoo, PA-C
- Physician Assistant
- Colorado Springs, CO
National Provider Identifier
1710099437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1872
- Practice address
- 13271 Bass Pro Dr Ste 140
Colorado Springs, CO 80921-3828 - Phone
- (888) 663-6331
- Fax
- (415) 252-7176
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1872 | CO | Primary |
Addresses
Primary practice location
13271 Bass Pro Dr Ste 140
Colorado Springs, CO 80921-3828
Mailing address
1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA.0001872 | Other | CO | STATE MEDICAL LICENSE |
Other names 1
- Carolyn Jean Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1872 | CO | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peakmed Colorado, LLC | Current | Accepting new patients | |
| Optumcare Colorado Medical Group LLC | Past | Accepting new patients |
Locations
13271 Bass Pro Dr
Ste 140
Colorado Springs, CO 80921
Phone (719) 394-8664
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Colorado Springs, CO
- NPI 1407623218
-
- General Practice Physician
- Colorado Springs, CO
- NPI 1407252828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1710099437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EMBARCADERO CTR STE 1900",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941113723",
"telephone_number": "415-658-6791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13271 BASS PRO DR STE 140",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809213828",
"telephone_number": "888-663-6331",
"fax_number": "415-252-7176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON-DRAGOO",
"first_name": "CAROLYN",
"middle_name": "J.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "1872",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "PA.0001872",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLYN",
"last_name": "JOHNSON",
"middle_name": "JEAN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.