Individual provider Active NPI

Johnathan Yeaton

  • Physical Therapist
  • Merrimack, NH
National Provider Identifier
1003330978
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
33 Wintergreen Dr
Merrimack, NH 03054-3959
Phone
(603) 930-4713
NPI assigned
Aug 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

33 Wintergreen Dr
Merrimack, NH 03054-3959

Mailing address

33 Wintergreen Dr
Merrimack, NH 03054-3959
Phone (603) 930-4713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201223002545 AK Practitioner - Physical Therapist in Private Practice 2062779937 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denali Physical Therapy Limited PartnershipGroup PAC ID 6507958501, 11 clinicians

Practice addresses (Care Compare)

3400 Latouche St
Suite 200
Anchorage, AK 99508-4208
Phone (907) 563-2122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy Inc Physical Therapist CurrentSince Jan 4, 2020 Accepting new patients
Denali Physical Therapy Limited Partnership Physical Therapist CurrentSince Aug 30, 2021 Accepting new patients

Locations

3400 Latouche St
Ste 200
Anchorage, AK 99508
Phone (907) 563-2122

360 Boniface Pkwy
Unit A26
Anchorage, AK 99504
Phone (907) 563-2141

1917 Abbott Rd
Ste 200
Anchorage, AK 99507
Phone (907) 279-4266

809 S Chugach St
Ste 1
Palmer, AK 99645
Phone (907) 745-2575

3051 E Palmer Wasilla Hwy
Wasilla, AK 99654
Phone (907) 352-4800

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003330978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WINTERGREEN DR",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030543959",
            "telephone_number": "603-930-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WINTERGREEN DR",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030543959",
            "telephone_number": "603-930-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEATON",
        "first_name": "JOHNATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrimack, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.