Active NPI
Dawn Michelle Johnson, PT, DPT, CSCS
- Physical Therapist
- Fruita, CO
National Provider Identifier
1104460286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0017149
- Practice address
- 551 Kokopelli Blvd Unit E
Fruita, CO 81521-6305 - Phone
- (970) 858-2526
- Fax
- (970) 858-8244
- NPI assigned
- Nov 1, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 06066 | OR | |
| Physical Therapist | 225100000X | PTL.0017149 | CO | Primary |
Addresses
Primary practice location
551 Kokopelli Blvd Unit E
Fruita, CO 81521-6305
Mailing address
PO Box 130
Fruita, CO 81521-0130
Phone (970) 858-2186
Other practice location 1
300 W Ottley Ave
Fruita, CO 81521-2118
Phone (970) 858-2575
Other practice location 2
1775 Thompson Rd
Coos Bay, OR 97420-2198
Phone (541) 269-8013
Other names 1
- Dawn Johnson
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
| License | State | Type | Specialty |
|---|---|---|---|
| 06066 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1104460286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130",
"city": "FRUITA",
"state": "CO",
"postal_code": "815210130",
"telephone_number": "970-858-2186",
"fax_number": "970-858-2208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "551 KOKOPELLI BLVD UNIT E",
"city": "FRUITA",
"state": "CO",
"postal_code": "815216305",
"telephone_number": "970-858-2526",
"fax_number": "970-858-8244"
}
],
"practiceLocations": [
{
"address_1": "300 W Ottley Ave",
"address_purpose": "LOCATION",
"city": "Fruita",
"state": "CO",
"postal_code": "815212118",
"country_code": "US",
"telephone_number": "970-858-2575",
"fax_number": "970-858-4569",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1775 Thompson Rd",
"address_purpose": "LOCATION",
"city": "Coos Bay",
"state": "OR",
"postal_code": "974202198",
"country_code": "US",
"telephone_number": "541-269-8013",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "DAWN",
"middle_name": "MICHELLE",
"credential": "PT, DPT, CSCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-01",
"last_updated": "2020-11-04",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "06066",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0017149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DAWN",
"last_name": "JOHNSON",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Fruita, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.