Organization Active NPI

Johnson and Johnson Physical Therapy LLC

  • Physical Medicine & Rehabilitation Physician
  • Detroit, MI
National Provider Identifier
1215293790
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
JOHNSON AND JOHNSON PHYSICAL THERAPY LLC
Practice address
17721 Fenkell St
Suite 112
Detroit, MI 48227-1513
Phone
(313) 659-3310
NPI assigned
Apr 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Authorized official

Name
Ms. Watsene Johnson
Title
Owner
Phone
(313) 463-1167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

17721 Fenkell St
Suite 112
Detroit, MI 48227-1513

Mailing address

17721 Fenkell St
Suite 112
Detroit, MI 48227-1513

National Provider Directory

National Provider Directory

Locations

17721 Fenkell St
Ste 112
Detroit, MI 48227
Phone (313) 659-3310

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347580800000",
    "number": "1215293790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17721 FENKELL ST",
            "address_2": "SUITE 112",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17721 FENKELL ST",
            "address_2": "SUITE 112",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271513",
            "telephone_number": "313-659-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON AND JOHNSON PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-09-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WATSENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-463-1167",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.