Individual provider Active NPI

Travis Johnston

  • Physical Therapist
  • Thornton, CO
National Provider Identifier
1043919608
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0020668 Issued in CO
Practice address
9351 Grant St Ste 430
Thornton, CO 80229-4365
Phone
(303) 280-1211
NPI assigned
Mar 2, 2023
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL26654 MA
Physical Therapist 225100000X PTL.0020668 CO Primary

Addresses

Primary practice location

9351 Grant St Ste 430
Thornton, CO 80229-4365

Mailing address

9351 Grant St Ste 430
Thornton, CO 80229-4365
Phone (303) 280-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314000917 MA Practitioner - Physical Therapist in Private Practice 9739553819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0020668COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Ma LLC Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Physiotherapy Associates Inc PastSince Jun 29, 2025 Accepting new patients
Physiotherapy Associates Inc PastSince Jun 29, 2025 Accepting new patients

Locations

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

7 Carnegie Plz
Cherry Hill, NJ 08003

Networks

  • Optimum HealthCare HMO Network

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": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1043919608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9351 GRANT ST STE 430",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294365",
            "telephone_number": "303-280-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9351 GRANT ST STE 430",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294365",
            "telephone_number": "303-280-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-02",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL26654",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0020668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.