Bryan Douglas Johnson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11824 Issued in MN

Practice address

2501 Rice Lake Rd
Duluth, MN 55811-4819

Phone

(864) 513-6864

NPI assigned

Jun 12, 2020

Sex

Male

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

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1174148308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "ESKO",
            "state": "MN",
            "postal_code": "557330004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 RICE LAKE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114819",
            "telephone_number": "864-513-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRYAN",
        "middle_name": "DOUGLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Therese Johnson
• Anastasia Marie Johnson
• Ashley Anna Johnson
• Benjamin H Johnson, MD
• Brooke Elizabeth Johnson, PA-C
• Cameron David Johnson, DO
• Carol Ann Johnson, LICSW
• Carol Katharine Miller Johnson, LMFT
• Chad Benjamin Johnson, PT
• Chad William Johnson

• Physical Therapist in Duluth, MN
• Providers in Duluth, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.