Individual provider Active NPI

Michael Alan Johnson, DPT

  • Physical Therapist
  • Harbor Springs, MI
National Provider Identifier
1164923983
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016078 Issued in MI
Practice address
1171 W Conway Rd
Harbor Springs, MI 49740-9684
Phone
(231) 487-6163
Fax
(231) 487-4615
NPI assigned
Feb 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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 5501016078 MI Primary

Addresses

Primary practice location

1171 W Conway Rd
Harbor Springs, MI 49740-9684

Mailing address

1171 W Conway Rd
Harbor Springs, MI 49740-9684
Phone (231) 487-6163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606001339 MI Practitioner - Physical Therapist in Private Practice 1951634963 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016078MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedic Solutions, PC CurrentSince May 6, 2019 Accepting new patients
Advanced Orthopedic Solutions, P.C. Physical Therapist Current Accepting new patients
Timothy I Bondy Inc PastSince Dec 1, 2024 Accepting new patients

Locations

2240 E Hill Rd
Ste H
Grand Blanc, MI 48439
Phone (810) 606-8766

2240 E Hill Rd
Grand Blanc, MI 48439
Phone (810) 579-0202

Organizations & group practices 3

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": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1164923983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 W CONWAY RD",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409684",
            "telephone_number": "231-487-6163",
            "fax_number": "231-487-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 W CONWAY RD",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409684",
            "telephone_number": "231-487-6163",
            "fax_number": "231-487-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-27",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor Springs, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.