Shawna Johnson, PTA
Individual provider Active NPI Physical Therapy Assistant · Charleston, AR
NPI 1104256296 · NPPES record last updated Nov 26, 2013
Key facts
- NPI
- 1104256296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA2773 (AR)
- Practice address
- 1919 Charmont Dr
Charleston, AR 72933-8910 - Phone
- (479) 965-6752
- NPI assigned
- Nov 26, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA2773 | AR | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Arkansas Pediatric Rehab Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA2773 | AR | Yes |
Addresses
Primary practice location
1919 Charmont Dr
Charleston, AR 72933-8910
Mailing address
PO Box 871
Charleston, AR 72933-0871
Phone (479) 965-6752
Other providers in Charleston, AR
- Brian E. Hawk
- Amber Lee Hertlein
- Hometown Pediatric Therapy Services
- Courtney Houston
- Margie Hyatt
- Rian Kearney
- Robert Jack Langston
- Le Western Dentistry, PLLC
- Leaps and Bounds Therapy Services, PLLC
- Suzanne M Little
All providers in Charleston, AR · Physical Therapy Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.