Individual provider Active NPI

Grace Caneta Johnson, PT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1225843774
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
865 Issued in NE
Practice address
8642 F St
Omaha, NE 68127-1639
Phone
(402) 393-9390
Fax
(402) 393-9388
NPI assigned
Feb 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 865 NE Primary

Addresses

Primary practice location

8642 F St
Omaha, NE 68127-1639

Mailing address

8642 F St
Omaha, NE 68127-1639
Phone (402) 393-9390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402002640 NE Practitioner - Physical Therapist in Private Practice 3274056973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizon Spine Rehabilitation IncGroup PAC ID 1557330446, 5 clinicians

Practice addresses (Care Compare)

8642 F St
Omaha, NE 68127-1639
Phone (402) 393-9390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
865NEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Spine Rehabilitation Inc Physical Therapist CurrentSince Mar 24, 2025 Accepting new patients
Horizon Spine Rehabilitation Inc Physical Therapist CurrentSince Mar 24, 2025 Accepting new patients
Horizon Spine Rehabilitation Physical Therapist Past Accepting new patients

Locations

1255 South St
Blair, NE 68008
Phone (402) 426-0600

8642 F St
Omaha, NE 68127
Phone (402) 393-9390

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1225843774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8642 F ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271639",
            "telephone_number": "402-393-9390",
            "fax_number": "402-393-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8642 F ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271639",
            "telephone_number": "402-393-9390",
            "fax_number": "402-393-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GRACE",
        "middle_name": "CANETA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.