Active NPI
Jessica Johnson, DPT
- Physical Therapist
- Appleton, WI
National Provider Identifier
1275855421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11339-24
- Practice address
- 3000 E College Ave
Appleton, WI 54915-3251 - Phone
- (920) 969-0919
- NPI assigned
- Feb 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 11339-24 | WI | Primary |
Addresses
Primary practice location
3000 E College Ave
Appleton, WI 54915-3251
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 969-0919
Other practice location 1
1305 W American Dr
Neenah, WI 54956
Phone (920) 729-7652
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11339-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1275855421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 NEENAH CTR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549563070",
"telephone_number": "920-969-0919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 E COLLEGE AVE",
"city": "APPLETON",
"state": "WI",
"postal_code": "549153251",
"telephone_number": "920-969-0919"
}
],
"practiceLocations": [
{
"address_1": "1305 W American Dr",
"address_purpose": "LOCATION",
"city": "Neenah",
"state": "WI",
"postal_code": "54956",
"country_code": "US",
"telephone_number": "920-729-7652",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "JESSICA",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-15",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11339-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.