Erin Kaitlyn Johnson, ATC, PTA

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000020757 Issued in IA

Practice address

112 2ND St NW
Waverly, IA 50677-2619

Phone

(319) 352-1012

NPI assigned

Aug 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1013434349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 10TH AVE SW APT 2",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506773775",
            "telephone_number": "515-227-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 2ND ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772619",
            "telephone_number": "319-352-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIN",
        "middle_name": "KAITLYN",
        "credential": "ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "084252",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "2000020757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwen Jensen, LMSW
• Sierra Jensen
• Mark H Jeppesen, OD
• Megan Marie Joerger
• Andrea Lynne Johnson, PMHNP-BC
• Scott B Johnson, PAC
• Josie Jones
• Julie Renee Kneip
• Kristin Kahler, DPT
• Madison Mae Kane

• Athletic Trainer in Waverly, IA
• Providers in Waverly, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.