Johnson's Functional Village, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

JOHNSON'S FUNCTIONAL VILLAGE, LLC

Doing business as

Johnson's Functional Village, LLC

Practice address

8000 Madison Blvd Ste D102-208
Madison, AL 35758-2031

Phone

(256) 299-5380

Fax

(256) 464-3045

NPI assigned

Apr 7, 2021

Last updated

Apr 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kattia-Nyde Champagne Johnson, OTR/L

Title

Occupational Therapist

Phone

(256) 299-5380

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Johnson's Functional Village, LLC Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1184203010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 MADISON BLVD STE D102-208",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582031",
            "telephone_number": "256-299-5380",
            "fax_number": "256-464-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 MADISON BLVD STE D102-208",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582031",
            "telephone_number": "256-299-5380",
            "fax_number": "256-464-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON'S FUNCTIONAL VILLAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KATTIA-NYDE",
        "authorized_official_middle_name": "CHAMPAGNE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "256-299-5380",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225481781",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "app.fusionwebclinic.com",
            "affiliation": "N",
            "endpointDescription": "Electronic EMR software",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Documentation",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Electronic EMR software",
            "address_1": "8000 Madison Blvd Ste D102-208",
            "city": "Madison",
            "state": "AL",
            "country_code": "US",
            "postal_code": "357582031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Johnson's Functional Village, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie J Johnson, RPT
• Steven E Johnson, M.D.
• Sydney Grace Johnson, CAA
• Tiffany Lawrence Johnson, CRNP
• Tiffany M Johnson, DPT
• Tina K Jones-Davis, LCSW
• Amorita Jones, DPT
• Arrie Jones
• Atyah Lajoy Jones, RN, BSN
• De'Arius Jones

• Pediatric Occupational Therapist in Madison, AL
• Providers in Madison, AL by specialty
• Pediatric Occupational Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.