Carlene E Johnson, OTD,OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT0000001542 Issued in TN

Practice address

6480 Peytonsville Arno Rd
College Grove, TN 37046

Phone

(615) 944-5649

NPI assigned

Oct 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Knoxville, TN
  • NPI 1306454558

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1053919977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 PEYTONSVILLE ARNO RD",
            "city": "COLLEGE GROVE",
            "state": "TN",
            "postal_code": "37046",
            "telephone_number": "615-944-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 PEYTONSVILLE ARNO RD",
            "city": "COLLEGE GROVE",
            "state": "TN",
            "postal_code": "37046",
            "telephone_number": "615-944-5649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Seaboard Ln Ste A4",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370678221",
            "country_code": "US",
            "telephone_number": "615-944-5649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARLENE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OTD,OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT0000001542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Mae Dunn, APRN-CNP, PMHNP-BC
• Patton Douglas Graham, NP-C
• Miranda Marie Grandolf
• Living Homes Inc. Dba Restore Independence
• Brandt Luke
• Kristina Lee Miller, M.S.
• My Liveability, LLC
• Marina Nessler, RDH

• Occupational Therapist in College Grove, TN
• Providers in College Grove, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.