Individual provider Active NPI

Jared Thornton Johnson

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1104310663
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP019173T Issued in WA
Practice address
4416 S Brandon St
Seattle, WA 98118-2341
Phone
(206) 721-3630
NPI assigned
Jun 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP019173T WA Primary
Physical Therapist 225100000X

Addresses

Primary practice location

4416 S Brandon St
Seattle, WA 98118-2341

Mailing address

1002 Saffell Rd
Reisterstown, MD 21136-6030
Phone (410) 596-9654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, RI, MD, WA5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20180822001837 DC Practitioner - Physical Therapist in Private Practice 4284983321 Reassigns benefits to 2 organizations
I20180911001755 VA Practitioner - Physical Therapist in Private Practice 4284983321 Reassigns benefits to 1 organization
I20221108002070 RI Practitioner - Physical Therapist in Private Practice 4284983321 Reassigns benefits to 1 organization
I20240621000620 MD Practitioner - Physical Therapist in Private Practice 4284983321 Reassigns benefits to 1 organization
I20241011000938 WA Practitioner - Physical Therapist in Private Practice 4284983321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
50.36 of 100Reported as group
Quality
43.71
Promoting interoperability
0
Improvement activities
40
Cost
74.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP019173TWAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Jun 7, 2024 Accepting new patients
Pappas Physical Therapy LLC Physical Therapist CurrentSince Aug 17, 2022 Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Jun 7, 2024 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist Current Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
Jackson Clinics Limited Partnership Physical Therapist CurrentSince Aug 1, 2018 Accepting new patients
Pappas Physical Therapy LLC CurrentSince Aug 17, 2022 Accepting new patients
Maryland Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jun 7, 2024 Accepting new patients
The Jackson Clinics LLC Physical Therapist PastSince Aug 1, 2018 Accepting new patients

Locations

5425 Wisconsin Ave
Ste 600
Chevy Chase, MD 20815
Phone (202) 223-3077

10980 Grantchester Way
Columbia, MD 21044
Phone (301) 202-1073

1100 Reservoir Ave
Cranston, RI 02910
Phone (401) 785-1016

1181 Aquidneck Ave
Middletown, RI 02842
Phone (401) 845-0840

730 Kingstown Rd
Unit A14
Wakefield, RI 02879
Phone (401) 284-3424

43490 Yukon Dr
Ashburn, VA 20147
Phone (703) 729-7920

12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033

13039 Worldgate Dr
Herndon, VA 20170
Phone (703) 689-3164

8140 Ashton Ave
Ste 104
Manassas, VA 20109
Phone (703) 257-3333

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

13242 Aurora Ave N
Ste 103
Seattle, WA 98133
Phone (206) 420-0221

201 W North River Dr
Ste 510
Spokane, WA 99201
Phone (509) 323-0066

Organizations & group practices 10

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1104310663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 SAFFELL RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366030",
            "telephone_number": "410-596-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4416 S BRANDON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182341",
            "telephone_number": "206-721-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JARED",
        "middle_name": "THORNTON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "CP019173T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.