Active NPI
Nicole Johnson, OT
- Occupational Therapist
- Towson, MD
National Provider Identifier
1215490677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 04856
- Practice address
- 6901 N Charles St
Towson, MD 21204-3780 - Phone
- (410) 284-8050
- NPI assigned
- Apr 11, 2019
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 04856 | MD | Primary |
Addresses
Primary practice location
6901 N Charles St
Towson, MD 21204-3780
Mailing address
613 Goodman Ave
Dundalk, MD 21222-1319
Phone (410) 284-8050
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04856 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554940800000",
"number": "1215490677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 GOODMAN AVE",
"city": "DUNDALK",
"state": "MD",
"postal_code": "212221319",
"telephone_number": "410-284-8050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6901 N CHARLES ST",
"city": "TOWSON",
"state": "MD",
"postal_code": "212043780",
"telephone_number": "410-284-8050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "NICOLE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-11",
"last_updated": "2019-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "04856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Towson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.