Individual provider Active NPI

Allison Johnson, PT

  • Geriatric Physical Therapist
  • Crystal Lake, IL
National Provider Identifier
1174984405
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
070007792 Issued in IL
Practice address
471 W Terra Cotta Ave
Crystal Lake, IL 60014-3434
Phone
(815) 455-0550
NPI assigned
Mar 15, 2016
Last updated
Mar 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 070007792 IL Primary

Addresses

Primary practice location

471 W Terra Cotta Ave
Crystal Lake, IL 60014-3434

Mailing address

471 W Terra Cotta Ave
Crystal Lake, IL 60014-3434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250122000586 MO Practitioner - Physical Therapist in Private Practice 0446789325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physical Therapy PCGroup PAC ID 9335190339, 27 clinicians

Practice addresses (Care Compare)

610 Hwy O
Gravois Mills, MO 65037-6221
Phone (877) 870-4976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070007792ILMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Physical Therapy, PC Geriatrics CurrentSince Jan 1, 2025 Accepting new patients

Locations

610 Highway O
Gravois Mills, MO 65037
Phone (573) 256-2777

3333 W 10th St
Sedalia, MO 65301
Phone (573) 256-2777

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1174984405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 W TERRA COTTA AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 W TERRA COTTA AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143434",
            "telephone_number": "815-455-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALLISON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "IL",
            "license": "070007792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.