Active NPI
Brianna Teresa Johnston, DPT
- Physical Therapist
- Ithaca, NY
National Provider Identifier
1225798911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 048109
- Practice address
- 10 Brentwood Dr
Ithaca, NY 14850-1865 - Phone
- (607) 274-4159
- NPI assigned
- Dec 22, 2021
- 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 | 048109 | NY | Primary |
Addresses
Primary practice location
10 Brentwood Dr
Ithaca, NY 14850-1865
Mailing address
101 Dates Dr
Ithaca, NY 14850-1383
Phone (607) 274-4011
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 |
|---|---|---|---|
| 048109 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1225798911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 DATES DR",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501383",
"telephone_number": "607-274-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 BRENTWOOD DR",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501865",
"telephone_number": "607-274-4159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "BRIANNA",
"middle_name": "TERESA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-22",
"last_updated": "2021-12-22",
"certification_date": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "048109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.