Evelyn - Johnson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50019 Issued in WI

Practice address

N27W5707 Lincoln Blvd
Cedarburg, WI 53012-2852

Phone

(262) 376-7676

Fax

(262) 376-5208

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316168115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 N 106TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262318",
            "telephone_number": "414-456-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N27W5707 LINCOLN BLVD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122852",
            "telephone_number": "262-376-7676",
            "fax_number": "262-376-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EVELYN",
        "middle_name": "-",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "50019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "50019",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40186700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASST.",
            "identifier": "22",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Alexander RN, MD,SC
• John Richard Jankowski, R.PH.
• Angela Marie Jiracek, PTA
• Ann V. John, OTR
• Alan L Johnson, DC
• Cara Jones, PT, DPT
• Kaylynn Julia Jones, APNP
• Kelly Elizabeth Jones
• Julie Chicks, M.D., S.C.
• Jenna Anne Jung

• Physical Therapy Assistant in Cedarburg, WI
• Providers in Cedarburg, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.