Kenneth Lee Johnson, P.T.,O.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501001186 Issued in MI

Practice address

740 Saint Clair St
Detroit, MI 48214-3660

Phone

(313) 822-3464

NPI assigned

Sep 3, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1114175098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48066",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482375766",
            "telephone_number": "313-822-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 SAINT CLAIR ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143660",
            "telephone_number": "313-822-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "P.T.,O.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501001186",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201003272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalimah Johnson, LMSW, ACSW
• Katrina Johnson, CPT
• Kayla Johnson
• Keith Donell Johnson
• Kenisha Lynette Johnson
• Kevin Johnson, S.W.
• Kiera Johnson
• Kimberly Johnson
• Kristin Johnson, MSW, LLMSW
• Kristina Lynn Johnson, RN, AGCNS-BC

• Physical Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.