Mackena Elsie Johnson

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

160645 Issued in AK

Practice address

Sports & Spinal Injury Clinic
6634 Lake Otis Pkwy #a
Anchorage, AK 99507

Phone

(907) 522-3511

NPI assigned

Sep 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sports & Spinal Injury Clinic,LLC

  • Chiropractor
  • Anchorage, AK
  • NPI 1568791093
  NPD
• Sports & Spinal Injury Clinic, LLC

  • Chiropractor
  • Anchorage, AK
  • NPI 1174719199
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1124634233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17031 VANOVER CIR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778130",
            "telephone_number": "907-980-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SPORTS & SPINAL INJURY CLINIC",
            "address_2": "6634 LAKE OTIS PKWY #A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99507",
            "telephone_number": "907-522-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MACKENA",
        "middle_name": "ELSIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "160645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Davon Johnson
• Libia Johnson
• Lila Johnson
• Lillian A Johnson, MD
• Lisa Anne Johnson, M.D.
• Madison Johnson
• Maiya Brielle Johnson
• Maria Ruthe Johnson, BSW
• Martha Pearl Johnson, M.S. CCC-SLP
• Mary Alice Johnson, M.D.

• Massage Therapist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.