MR. NICHOLAS DAVID JOHNSON PA
NPI 1427558477
Physician Assistant - Medical in Grand Rapids, MI
NPI Status: Active since February 16, 2018
Contact Information
200 JEFFERSON AVE SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 685-5000
- Individual
- Male
- Physician Assistant
- Medical
- Accepts Insurance
- PECOS Enrolled
About NICHOLAS JOHNSON
This page provides the complete NPI Profile along with additional information for Nicholas Johnson, a primary care provider established in Grand Rapids, Michigan with a medical specialization in Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1427558477 assigned on February 2018. The practitioner's primary taxonomy code is 363AM0700X with license number 5601008568 (MI). The provider is registered as an individual and his NPI record was last updated 8 years ago.
- NPI
- 1427558477
- Provider Name
- MR. NICHOLAS DAVID JOHNSON PA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503
- Location Phone
- (616) 685-5000
- Mailing Address
- 1900 44TH ST SE KENTWOOD, MI 49508
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-16-2018
- Last Update Date
- 02-16-2018
- Code Navigator
A primary care provider (PCP) like Nicholas Johnson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 5601008568
- License State
- MI
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- Bronze First - HMO
- Bronze First Adult Vision & Fitness - HMO
- Diabetes Gold - HMO
- Diabetes Gold Adult Vision & Fitness - HMO
- Diabetes Silver - HMO
- Diabetes Silver Adult Vision & Fitness - HMO
- Gold - HMO
- Gold Adult Vision & Fitness - HMO
- HDHP Preventive Silver - HMO
- Healthy Heart Gold - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Simple PCP Saver - EPO
- MyPriority Balanced Silver - HMO
- MyPriority Premier Silver - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Travel - HMO
- MyPriority Standard Gold - HMO
- MyPriority Standard Silver - HMO
- MyPriority Standard Silver - Travel - HMO
- MyPriority Value Bronze - HMO
- MyPriority Value Bronze HSA - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Nicholas Johnson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for MR. NICHOLAS DAVID JOHNSON PA
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 2 | 7 | 5 | 5 | 8 | 4 | 7 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 10 | 5 | 16 | 4 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 1 + 0 + 5 + 1 + 6 + 4 + 1 + 4 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1427558477 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1902806755 | DR. GERALD ROBERT DEYOUNG Individual | Pharmacist (Pharmacotherapy) | 200 JEFFERSON AVE SE ADVANTAGE HEALTH PHYSICIANS AND ST. MARY'S HEALTH CARE GRAND RAPIDS, MI 49503 (616) 752-6410 |
| 1972598340 | MARK FIGURSKI MD Individual | Emergency Medicine | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1114912581 | DONALD FINDLAY DO Individual | Emergency Medicine | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1326033721 | MICHAEL OLGREN MD Individual | Emergency Medicine (Emergency Medical Services) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1831184233 | DANIEL ROPER MD Individual | Emergency Medicine (Emergency Medical Services) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1982699203 | NILDA M OXHOLMURIBE MD Individual | Emergency Medicine (Emergency Medical Services) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1083609374 | JAMES DERNOCOEUR PA Individual | Physician Assistant (Medical) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1447245501 | MARK MILLER DO Individual | Emergency Medicine (Emergency Medical Services) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1043205123 | STEVEN PERRY DO Individual | Emergency Medicine | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1194710111 | PHILIP VANLENTE MD Individual | Emergency Medicine (Emergency Medical Services) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1669467494 | DR. BRIAN JAMES BERRYHILL PHARM.D. Individual | Pharmacist | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (616) 752-6943 |
| 1821070087 | MR. TERRY K KIRKPATRICK MS, RPH Individual | Pharmacist | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (616) 685-6108 |
| 1497724207 | MRS. SHERYL LYNN VEURINK-BALICKI R.N. Individual | Registered Nurse (Emergency) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (616) 752-6798 |
| 1275591414 | JENNIFER J EKKENS DO Individual | Emergency Medicine | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (800) 968-6866 |
| 1679524284 | RONALD DUEMLER MD Individual | Family Medicine (Geriatric Medicine) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (616) 685-1835 |
| 1841242898 | GLENES HAMERSMA GNP-C Individual | Nurse Practitioner | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (616) 685-1835 |
| 1568414225 | MERLE KOOPS PA-C Individual | Physician Assistant | 200 JEFFERSON AVE SE 6 SOUTH #626 GRAND RAPIDS, MI 49503 (616) 685-5039 |
| 1043263544 | ELIZABETH NEUBIG MD Individual | Internal Medicine | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (616) 685-1835 |
| 1225081672 | ROBERT RIEKSE MD Individual | Internal Medicine (Geriatric Medicine) | 200 JEFFERSON AVE SE GRAND RAPIDS, MI 49503 (616) 685-1835 |
| 1700839974 | SARAH CHUDY PA-C Individual | Physician Assistant | 200 JEFFERSON AVE SE 6 SOUTH #626 GRAND RAPIDS, MI 49503 (616) 685-5039 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427558477, enumerated in the NPI registry as an "individual" on February 16, 2018
The provider is located at 200 Jefferson Ave Se Grand Rapids, Mi 49503 and the phone number is (616) 685-5000
The provider's speciality is Physician Assistant with taxonomy code 363AM0700X with a focus in Medical
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on February 16, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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