Southeast First Assistant LLC
NPI 1790158459ActiveOrganization· Physician Assistant, Surgical· Athol, ID
Physician Assistant, Surgical in Athol, Idaho, registered in NPPES in November 2015. The authorized official on file is Drew Johnson, PAC, Owner.
Overview
| NPI | 1790158459 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 3, 2015 |
| Last updated in NPPES | Nov 3, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | PA-1167 | ID |
| Physician Assistant | 363A00000X | PA-1167 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|