Breanna Johnson

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2668-19 Issued in WI

Practice address

700 Geneva Pkwy N
Lake Geneva, WI 53147-4594

Phone

(262) 249-3500

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

No

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

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1134748916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3670 WILDWOOD DR",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531473567",
            "telephone_number": "847-431-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 GENEVA PKWY N",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474594",
            "telephone_number": "262-249-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2668-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Vincent Jacobson, PTA
• Jacquelyn Leigh Janaky
• Jelka, LLC
• Seon Yeop Jeong, MD
• Carling M. Johns, DPT
• Joint School District #1, City of Lake Geneva Et Al
• Ryan Christopher Jolly, ATC, EMT-B
• Kaiser Chiropractic, S.C.
• Christopher A Kaiser, DC
• Jennifer Frye Keefe, M.A.

• Physical Therapy Assistant in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.