Active NPI
Jordan Johnston, DPT
- Physical Therapist
- St Maries, ID
National Provider Identifier
1225786064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-5286
- Practice address
- 229 S 7TH St
St Maries, ID 83861-1803 - Phone
- (208) 245-5551
- NPI assigned
- Mar 11, 2022
- Sex
- Male
- 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 | PT-5286 | ID | Primary |
Addresses
Primary practice location
229 S 7TH St
St Maries, ID 83861-1803
Mailing address
11204 E 44TH Ave
Spokane Valley, WA 99206-9414
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 |
|---|---|---|---|
| PT-5286 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646956800000",
"number": "1225786064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11204 E 44TH AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992069414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 S 7TH ST",
"city": "ST MARIES",
"state": "ID",
"postal_code": "838611803",
"telephone_number": "208-245-5551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "JORDAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-11",
"last_updated": "2022-03-11",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-5286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Maries, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.