Stephanie Jane Johnson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT872612 Issued in DC

Practice address

1145 19TH St NW
Washington, DC 20036-3701

Phone

(202) 861-0512

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Clinics Limited PartnershipGroup PAC ID 2860623295, 116 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jackson Clinics Limited Partnership

  • Physical Therapist
  • Centreville, VA
  • NPI 1639594831

  DC

  Medicare reassignment Care Compare group NPD
• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1174177893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 UHLAND TER NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021321",
            "telephone_number": "240-394-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 19TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200363701",
            "telephone_number": "202-861-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT872612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjjohnson@gwu.edu",
            "affiliation": "Y",
            "endpointDescription": "school email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2121 I St NW",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200520086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shy Johnson
• Sophia Johnson
• Sparkle S Johnson
• Stephanie Johnson
• Stephanie Johnson, HHA
• Stephanie Renee Johnson, PHD
• Steven Parnell Johnson, MD
• Sydney Marie Johnson, MD
• Symone Shante Johnson
• Synthia Dianne Johnson, MSW, LICSW

• Physical Therapist in Washington, DC
• Providers in Washington, DC by specialty
• Physical Therapist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.