Beau Q Johnson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11650 Issued in WI

Practice address

1303 S Main St
Holmen, WI 54636

Phone

(608) 785-0940

NPI assigned

Oct 19, 2006

Last updated

Sep 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bjohnson26339@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - La Crosse

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1629056049
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - La Crosse

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1942980917
  NPD

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1316029358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 S MAIN ST",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "54636",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 West Avenue S",
            "address_purpose": "LOCATION",
            "city": "La Crosse",
            "state": "WI",
            "postal_code": "546014783",
            "country_code": "US",
            "telephone_number": "607-392-9768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 West Avenue S",
            "address_purpose": "LOCATION",
            "city": "La Crosse",
            "state": "WI",
            "postal_code": "546014783",
            "country_code": "US",
            "telephone_number": "607-392-9768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BEAU",
        "middle_name": "Q",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "5231022-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjohnson26339@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1303 S Main St",
            "city": "Holmen",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Callie Mae Horstman, DC
• Jade Mary Hudson
• Paula Jo Hueners, OTR
• Amanda Lee Eckhardt Hyland, D.D.S
• Katherine Marie Jameson
• Julia K Johnson, M.S.,CCC-SLP
• Steven W Johnson, DPT
• Jones Family Chiropractic, LLC
• Sheridan Kaatz
• Olyvia Rae Kenworthy

• Physical Therapist in Holmen, WI
• Providers in Holmen, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.