Individual provider Active NPI

Jean Ann Johnson, PHYSICAL THERAPIST

  • Physical Therapist
  • Aiken, SC
National Provider Identifier
1265076137
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9958 Issued in SC
Practice address
1397 Silver Bluff Rd Ste 100
Aiken, SC 29803-9784
Phone
(803) 220-1073
NPI assigned
Nov 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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 9958 SC Primary

Addresses

Primary practice location

1397 Silver Bluff Rd Ste 100
Aiken, SC 29803-9784

Mailing address

105 Highcrest LN
Lexington, SC 29072-7737
Phone (321) 263-1891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191226001811 SC Practitioner - Physical Therapist in Private Practice 5890129936 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

3620 Walton Dr
Unit C5 and C6
Myrtle Beach, SC 29577-6781
Phone (843) 353-3460

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9958SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients
Fox Rehabilitation Services of South Carolina, LLC Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients
Orthosc, LLC CurrentSince Jan 18, 2023 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Nov 1, 2019 Accepting new patients
Orthosc, LLC CurrentSince Jan 18, 2023 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Nov 1, 2019 Accepting new patients
Orthosc, LLC PastSince May 29, 2022 Accepting new patients

Locations

33205 Collection Ctr Dr
Chicago, IL 60693

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

1397 Silver Bluff Rd
Ste 100
Aiken, SC 29803
Phone (803) 220-1073

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

3620 Walton Dr
Unit C5
Myrtle Beach, SC 29577

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jean.johnson.1@17161.direct.athenahealth.com

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1265076137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HIGHCREST LN",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727737",
            "telephone_number": "321-263-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 SILVER BLUFF RD STE 100",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298039784",
            "telephone_number": "803-220-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEAN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "9958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.