Individual provider Active NPI

Gail Marie Johnson, MPT

  • Physical Therapist
  • Frederick, MD
National Provider Identifier
1154764033
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19640 Issued in MD
Practice address
626 Trail Ave
Frederick, MD 21701-4934
Phone
(301) 662-1997
Fax
(301) 668-2202
NPI assigned
Apr 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19640 MD Primary

Addresses

Primary practice location

626 Trail Ave
Frederick, MD 21701-4934

Mailing address

5506 Bootjack Dr
Frederick, MD 21702-2306
Phone (301) 631-2185

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Homecare Rehab, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1154764033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 BOOTJACK DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022306",
            "telephone_number": "301-631-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 TRAIL AVE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014934",
            "telephone_number": "301-662-1997",
            "fax_number": "301-668-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GAIL",
        "middle_name": "MARIE",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.