Active NPI
Tonika Johnson
- Occupational Therapist
- Port Orange, FL
National Provider Identifier
1003177080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 07528
- Practice address
- 5535 S Williamson Blvd
Suite 774
Port Orange, FL 32128-8311 - Phone
- (386) 756-4395
- Fax
- (386) 944-7202
- NPI assigned
- Jun 6, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 15251 | FL | |
| Occupational Therapist | 225X00000X | 114800 | TX | |
| Occupational Therapist | 225X00000X | 07528 | MD | Primary |
Addresses
Primary practice location
5535 S Williamson Blvd
Suite 774
Port Orange, FL 32128-8311
Mailing address
6801 Sienna Club PL
Lauderhill, FL 33319-7317
Phone (954) 600-5676
Other practice location 1
5980 Radio Station Rd
LA Plata, MD 20646-3337
Phone (301) 932-6610
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15251 | FL | MD | Clinical Social Worker |
| 07528 | MD | MD | Occupational Therapist |
| 114800 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1003177080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6801 SIENNA CLUB PL",
"city": "LAUDERHILL",
"state": "FL",
"postal_code": "333197317",
"telephone_number": "954-600-5676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5535 S WILLIAMSON BLVD",
"address_2": "SUITE 774",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321288311",
"telephone_number": "386-756-4395",
"fax_number": "386-944-7202"
}
],
"practiceLocations": [
{
"address_1": "5980 Radio Station Rd",
"address_purpose": "LOCATION",
"city": "LA Plata",
"state": "MD",
"postal_code": "206463337",
"country_code": "US",
"telephone_number": "301-932-6610",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "TONIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-06",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "15251",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "114800",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "07528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.