Individual provider Active NPI

Johanna Ewican

  • Physical Therapist
  • Westfield, IN
National Provider Identifier
1194175059
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.019953 Issued in IL
Practice address
14902 Shelborne Rd
Westfield, IN 46074-9668
Phone
(317) 286-2885
Fax
(317) 536-3097
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.019953 IL Primary

Addresses

Primary practice location

14902 Shelborne Rd
Westfield, IN 46074-9668

Mailing address

14902 Shelborne Rd
Westfield, IN 46074-9668
Phone (317) 286-2885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070.019953ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1194175059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14902 SHELBORNE RD",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749668",
            "telephone_number": "317-286-2885",
            "fax_number": "317-536-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14902 SHELBORNE RD",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749668",
            "telephone_number": "317-286-2885",
            "fax_number": "317-536-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWICAN",
        "first_name": "JOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.019953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.