Nicole R Johnson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA005142 Issued in GA

Practice address

55 E Paulding Dr
Dallas, GA 30157-7191

Phone

(470) 648-2038

NPI assigned

Aug 18, 2025

Last updated

Aug 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1063399590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E PAULDING DR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301577191",
            "telephone_number": "470-648-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E PAULDING DR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301577191",
            "telephone_number": "470-648-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA005142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jetts Way LLC
• JJD Professional Care and Health Services LLC
• Jno, Inc. (Visiting Angels)
• Delana Lynn Job, LPN
• Bethany Ilean Johnson
• Sydney Alexandra Johnson
• Zandra Johnson, LPN
• Kaitlyn Marie Johnston, DPT
• Olumide Jolayemi
• Abigail Jones

• Physical Therapy Assistant in Dallas, GA
• Providers in Dallas, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.