Mattea Johnson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2225 Issued in ND

Practice address

3120 25TH St S Ste N
Fargo, ND 58103-6110

Phone

(701) 205-4194

NPI assigned

Aug 11, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Great Kids Therapy, LTD

  • Occupational Therapist
  • Fargo, ND
  • NPI 1558743013
  Medicare reassignment NPD
• Great Kids Therapy, LTD.

  • Occupational Therapist
  • Fargo, ND
  • NPI 1497805196
  NPD

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1033094792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 25TH ST S STE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 25TH ST S STE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036110",
            "telephone_number": "701-205-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTEA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "2225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Johnson
• Lisa Marie Johnson, R.PH, PHARM.D.
• Lucy M Johnson, CNS
• Mary A Johnson, LSW
• Mathew Johnson, PT, DPT
• Matthew Christopher Johnson, MD
• Max Ray Johnson, MD
• Meghan Johnson, DPT
• Melanie Kathryn Johnson, OTR/L
• Merrick Johnson, MD

• Occupational Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.