Individual provider Active NPI

Melissa J Johnson, OTR

  • Pediatric Occupational Therapist
  • Gilbert, AZ
National Provider Identifier
1124199898
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
3865 Issued in AZ
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

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
OT 006597OHMDOccupational Therapist

Interoperability endpoints

  • FHIR API: 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.

Verify at the official NPI Registry.