Ellyse Johns, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305207547 Issued in VA

Practice address

95 Medical Park Blvd
Petersburg, VA 23805-9280

Phone

(804) 504-8100

Fax

(804) 504-7795

NPI assigned

Nov 7, 2014

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1184020828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059280",
            "telephone_number": "804-504-8100",
            "fax_number": "804-504-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059280",
            "telephone_number": "804-504-8100",
            "fax_number": "804-504-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "ELLYSE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernest Jeter
• Rose R Jeter, LCSW
• Xiao Hong Jin, MD
• John T. Marshall M.D P.C
• John W Lynn DDS LTD
• Ashley P B Johnson, CD, BEC
• Brendan Johnson
• Daijah Johnson, PTCB, LCPC, LMHC
• Danna Elizabeth Johnson, MD
• Debra M Johnson

• Physical Therapist in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.