Jeanna Johnson, PHYSICAL THERAPIST

Individual provider Active NPI Physical Therapist · Smiths Grove, KY

NPI 1033764972 · NPPES record last updated Aug 7, 2019

Key facts

NPI
1033764972
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
000925 (KY)
Practice address
75 River Birch Loop
Smiths Grove, KY 42171-7310
Phone
(270) 535-1414
NPI assigned
Aug 7, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000925KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McReynolds Physical Therapy, PLLC Physical Therapist Past
since Aug 11, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 000925 KY Yes

Addresses

Primary practice location

75 River Birch Loop
Smiths Grove, KY 42171-7310

Mailing address

275 New Towne Rd Apt 104
Bowling Green, KY 42103-7997
Phone (252) 903-6375

Other providers in Smiths Grove, KY

All providers in Smiths Grove, KY · Physical Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.