Active NPI
Patricia Jacoby Johnson, P.T.
- Physical Therapist
- Menomonee Falls, WI
National Provider Identifier
1205971736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4556 - 024
- Practice address
- N88W16598 Main St
Menomonee Falls, WI 53051-2845 - Phone
- (262) 502-0028
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4556 - 024 | WI | Primary |
Addresses
Primary practice location
N88W16598 Main St
Menomonee Falls, WI 53051-2845
Mailing address
3844 Oak Ridge CT
Colgate, WI 53017-9361
Phone (262) 628-1975
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4556 - 024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1205971736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3844 OAK RIDGE CT",
"city": "COLGATE",
"state": "WI",
"postal_code": "530179361",
"telephone_number": "262-628-1975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N88W16598 MAIN ST",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530512845",
"telephone_number": "262-502-0028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "PATRICIA",
"middle_name": "JACOBY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "4556 - 024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.