Active NPI
Kenneth Byron Johnson, PHYSICAL THERAPIST
- Physical Therapist
- Unalaska, AK
National Provider Identifier
1043756414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PHYP2225
- Practice address
- 36 Lavelle Court
Unalaska, AK 99685 - Phone
- (907) 581-1202
- NPI assigned
- Jan 10, 2017
- Last updated
- Jan 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PHYP2225 | AK | Primary |
Addresses
Primary practice location
36 Lavelle Court
Unalaska, AK 99685
Mailing address
PO Box 921103
Dutch Harbor, AK 99692-1103
Phone (907) 359-3585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHYP2225 | AK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iliuliuk Family &Health Services, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba IFHS Pharmacy
- Community/Retail Pharmacy
- Unalaska, AK
- NPI 1760340905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1043756414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 921103",
"city": "DUTCH HARBOR",
"state": "AK",
"postal_code": "996921103",
"telephone_number": "907-359-3585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 LAVELLE COURT",
"city": "UNALASKA",
"state": "AK",
"postal_code": "99685",
"telephone_number": "907-581-1202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KENNETH",
"middle_name": "BYRON",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-10",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "PHYP2225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Unalaska, AK
- Valerie Hupe
- Iliuliuk Family &Health Services, Inc.
- Iliuliuk Family &Health Services, Inc. (IFHS Pharmacy)
- Iliuliuk Family and Health Services Inc
- James Mushovic, D.M.D., Inc
- Maria Green Kallman, PA
- Christine Lynn King, LICENSED DISPENSING
- Arnold Terry Magy
- Morris Health & Wellness Assoc LLC (Aleutian Chiropractic Health Center)
- Morris PT & Movement Associates LLC (Haystack Physical Therapy Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.