MEDICARE: CONNOR LEE JOHNSON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA.0009589	CO
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1982443065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNOR LEE JOHNSON PA

Provider Business Mailing Address
First Line	:	395 W COUGAR BLVD STE 503
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-3323
Country	:	US
Telephone Number	:	801-357-4600
Fax Number	:	385-297-2832

Provider Business Practice Location Address
First Line	:	395 W COUGAR BLVD STE 503
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-3323
Country	:	US
Telephone Number	:	801-357-4600
Fax Number	:	385-297-2832

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	02/09/2026

Similar Medicare Providers

1386638005 — JAMES RIELLY
Practice Location Address:

395 W COUGAR BLVD STE 503
PROVO, UT
84604-3323

Practice Phone: 801-374-9100
Practice Fax: 801-374-9117

1467460246 — DOUGLAS K WORTHINGTON AUD
Practice Location Address:

395 W COUGAR BLVD STE 501
PROVO, UT
84604-3323

Practice Phone: 801-357-4945
Practice Fax: 801-357-7527

1205931037 — SAMER ABDELWAHAB SALEH M.D.
Practice Location Address:

395 W COUGAR BLVD FL 5
PROVO, UT
84604-3323

Practice Phone: 801-357-7291
Practice Fax:

1225165988 — IHC HEALTH SERVICES INC
Practice Location Address:

395 W COUGAR BLVD STE 503
PROVO, UT
84604-3323

Practice Phone: 801-357-7081
Practice Fax:

1295862951 — IHC HEALTH SERVICES INC
Practice Location Address:

395 W COUGAR BLVD STE 504
PROVO, UT
84604-3323

Practice Phone: 801-357-7291
Practice Fax:

1831390038 — IHC HEALTH SERVICES INC
Practice Location Address:

395 W COUGAR BLVD STE 501
PROVO, UT
84604-3323

Practice Phone: 801-357-4945
Practice Fax:

Directions to “ CONNOR LEE JOHNSON PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.