Individual provider Active NPI

Peter M Johnson, DPT

  • Physical Therapist
  • Erlanger, KY
National Provider Identifier
1073220430
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008687 Issued in KY
Practice address
600 Rodeo Dr
Erlanger, KY 41018-1279
Phone
(513) 815-5585
Fax
(859) 342-0079
NPI assigned
Nov 3, 2022
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 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 008687 KY Primary

Addresses

Primary practice location

600 Rodeo Dr
Erlanger, KY 41018-1279

Mailing address

6480 Harrison Ave Ste 201
Cincinnati, OH 45247-7961
Phone (513) 354-7662

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

LicenseStateTypeSpecialty
008687KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine, LTD Physical Therapist CurrentSince Nov 3, 2022 Accepting new patients
Beacon Orthopaedics & Sports Medicine LTD CurrentSince Nov 3, 2022 Accepting new patients

Locations

600 Rodeo Dr
Erlanger, KY 41018
Phone (513) 574-5400

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

Interoperability endpoints

  • Direct secure messaging: peter.johnson.p1@direct.beaconortho.nextgenshare.com

Organizations & group practices 2

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1073220430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE STE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-7662",
            "fax_number": "513-354-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 RODEO DR",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410181279",
            "telephone_number": "513-815-5585",
            "fax_number": "859-342-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "008687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erlanger, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.