Individual provider Active NPI

Ann Johnson

  • Physical Therapist
  • Minnetonka, MN
National Provider Identifier
1033329008
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3055 Issued in MN
Practice address
3836 Oak Rd
Minnetonka, MN 55345-1936
Phone
(952) 931-9033
NPI assigned
May 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3055 MN Primary

Addresses

Primary practice location

3836 Oak Rd
Minnetonka, MN 55345-1936

Mailing address

3836 Oak Rd
Minnetonka, MN 55345-1936
Phone (952) 931-9033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240320003053 MN Practitioner - Physical Therapist in Private Practice 6002253465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optage IncGroup PAC ID 2264619345, 61 clinicians

Practice addresses (Care Compare)

5330 Beacon Hill Rd
Minnetonka, MN 55345-5858
Phone (651) 631-6570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optage Inc Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients
Optage Inc Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients
Optage Inc Physical Therapist Current Accepting new patients

Locations

2845 Hamline Ave N
Saint Paul, MN 55113
Phone (651) 631-6100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033329008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3836 OAK RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553451936",
            "telephone_number": "952-931-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3836 OAK RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553451936",
            "telephone_number": "952-931-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "3055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.