Tommie E Johnson Jr.

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

LMT MT108519 Issued in TX

Practice address

1420 US Highway 271 N Ste a
Gilmer, TX 75644-4132

Phone

(903) 797-2729

Fax

(903) 797-2729

NPI assigned

Mar 9, 2010

Last updated

Mar 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1144543869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 US HIGHWAY 271 N. SUITE A",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756444132",
            "telephone_number": "903-797-2729",
            "fax_number": "903-797-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 US HIGHWAY 271 N STE A",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756444132",
            "telephone_number": "903-797-2729",
            "fax_number": "903-797-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TOMMIE",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "LMT MT108519",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "TX",
            "license": "LMT MT108519",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "LMT MT108519",
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "TX",
            "license": "LMT MT108519",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "LMT MT108519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elvin Ray Kennedy
• Wanda Marie Kennel, LCDC, LSBW

• Rehabilitation Practitioner in Gilmer, TX
• Providers in Gilmer, TX by specialty
• Rehabilitation Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.