Active NPI
Melissa J Johnson, OTR
- Pediatric Occupational Therapist
- Gilbert, AZ
National Provider Identifier
1124199898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 3865
- Practice address
- 4001 E Baseline Rd
Ste B2
Gilbert, AZ 85234-2726 - Phone
- (480) 539-5629
- Fax
- (480) 539-5669
- NPI assigned
- Nov 13, 2006
- 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 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 006597 | OH | |
| Ergonomics Occupational Therapist | 225XE1200X | OT 006597 | OH | |
| Human Factors Occupational Therapist | 225XH1300X | OT 006597 | OH | |
| Neurorehabilitation Occupational Therapist | 225XN1300X | OT 006597 | OH | |
| Pediatric Occupational Therapist | 225XP0200X | OT 006597 | OH | |
| Occupational Therapist | 225X00000X | 3865 | AZ | |
| Pediatric Occupational Therapist | 225XP0200X | 3865 | AZ | Primary |
| Neurorehabilitation Occupational Therapist | 225XN1300X | 3865 | AZ |
Addresses
Primary practice location
4001 E Baseline Rd
Ste B2
Gilbert, AZ 85234-2726
Mailing address
1295 N Ash St
Apt. #816
Gilbert, AZ 85233-2767
Phone (810) 599-3150
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 006597 | OH | MD | Occupational Therapist |
Interoperability endpoints
- https://api.platform.athenahealth.com/2428/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1124199898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1295 N ASH ST",
"address_2": "APT. #816",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852332767",
"telephone_number": "810-599-3150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 E BASELINE RD",
"address_2": "STE B2",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342726",
"telephone_number": "480-539-5629",
"fax_number": "480-539-5669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MELISSA",
"middle_name": "J",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT 006597",
"primary": false
},
{
"code": "225XE1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Ergonomics",
"state": "OH",
"license": "OT 006597",
"primary": false
},
{
"code": "225XH1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Human Factors",
"state": "OH",
"license": "OT 006597",
"primary": false
},
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "OH",
"license": "OT 006597",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "OH",
"license": "OT 006597",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "3865",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AZ",
"license": "3865",
"primary": true
},
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "AZ",
"license": "3865",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.