Individual provider Active NPI

Alexandria Johnson, DPT

  • Physical Therapist
  • St Francis, WI
National Provider Identifier
1043049794
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16906-24 Issued in WI
Practice address
2000 E Layton Ave
St Francis, WI 53235-6053
Phone
(414) 747-8400
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 16906-24 WI Primary

Addresses

Primary practice location

2000 E Layton Ave
St Francis, WI 53235-6053

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

5333 N Port Washington Rd Ste B
Glendale, WI 53217-4914
Phone (414) 716-1770

Other identifiers 1

IdentifierTypeStateIssuer
100294719MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ajohnson412269@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240905003672 WI Practitioner - Physical Therapist in Private Practice 2567902430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16906-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Aug 2, 2024 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Aug 2, 2024 Accepting new patients

Locations

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

5333 N Port Washington Rd
Ste B
Glendale, WI 53217
Phone (414) 716-1770

11363 N Port Washington Rd
Mequon, WI 53092
Phone (262) 833-2060

Interoperability endpoints

  • Direct secure messaging: ajohnson412269@direct.myadvocateaurora.org

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, 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": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1043049794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAYTON AVE",
            "city": "ST FRANCIS",
            "state": "WI",
            "postal_code": "532356053",
            "telephone_number": "414-747-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5333 N Port Washington Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532174914",
            "country_code": "US",
            "telephone_number": "414-716-1770",
            "fax_number": "414-716-1772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALEXANDRIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16906-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100294719",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajohnson412269@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2000 E Layton Ave",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2000 E Layton Ave",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Francis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.