Individual provider Active NPI

Megan Alyse Johnson, DPT

  • Physical Therapist
  • Spokane Valley, WA
National Provider Identifier
1043946007
Registry record updated Jul 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PU61313275 Issued in WA
Practice address
12615 E Mission Ave Ste 109
Spokane Valley, WA 99216-1047
Phone
(509) 891-2623
NPI assigned
Jul 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2022

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 PU61313275 WA Primary

Addresses

Primary practice location

12615 E Mission Ave Ste 109
Spokane Valley, WA 99216-1047

Mailing address

12615 E Mission Ave Ste 109
Spokane Valley, WA 99216-1047
Phone (509) 891-2623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919000784 WA Practitioner - Physical Therapist in Private Practice 0749665347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Royter Physical Therapy IncGroup PAC ID 0345249447, 8 clinicians

Practice addresses (Care Compare)

2772 S Grand Blvd
Spokane, WA 99203-2526
Phone (509) 456-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PU61313275WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake City Physical Therapy P a Physical Therapist CurrentSince Aug 5, 2022 Accepting new patients
Royter Physical Therapy Inc Physical Therapist CurrentSince Sep 17, 2023 Accepting new patients
Advanced Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

2170 W Ironwood Center Dr
Coeur D Alene, ID 83814
Phone (208) 667-1988

2170 W Ironwood Center Dr
Ste B
Coeur D Alene, ID 83814
Phone (208) 667-1988

2772 S Grand Blvd
Spokane, WA 99203
Phone (509) 456-0888

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659139200000",
    "number": "1043946007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 E MISSION AVE STE 109",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161047",
            "telephone_number": "509-891-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 E MISSION AVE STE 109",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161047",
            "telephone_number": "509-891-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MEGAN",
        "middle_name": "ALYSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-30",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PU61313275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; 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.