Individual provider Active NPI

Sharon Evette Johnson, PHYSICAL THERAPY

  • Physical Therapist
  • Lanham, MD
National Provider Identifier
1114525441
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17534 Issued in MD
Practice address
9470 Annapolis Rd Ste 416
Lanham, MD 20706-3000
Phone
(240) 770-3505
NPI assigned
Oct 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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 17534 MD Primary

Addresses

Primary practice location

9470 Annapolis Rd Ste 416
Lanham, MD 20706-3000

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103000379 DC Practitioner - Physical Therapist in Private Practice 4486064466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

11271 New Hampshire Ave
Ati Physical Therapy
Silver Spring, MD 20904-2631
Phone (240) 485-1280

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Jul 12, 2021 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Jul 12, 2021 Accepting new patients
Ati Holdings, LLC Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

Organizations & group practices 3

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": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1114525441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470 ANNAPOLIS RD STE 416",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063000",
            "telephone_number": "240-770-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHARON",
        "middle_name": "EVETTE",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.