Melissa Johnson

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA10749 Issued in FL

Practice address

1101 Parc Hill Blvd
Orange City, FL 32763-8029

Phone

(386) 960-8277

Fax

(857) 290-9134

NPI assigned

May 28, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mjohnson@ageility.com

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1316513617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 ALDER DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279255",
            "telephone_number": "386-451-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PARC HILL BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638029",
            "telephone_number": "386-960-8277",
            "fax_number": "857-290-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA10749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mjohnson@ageility.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1101 Parc Hill Blvd",
            "city": "Orange City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327638029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Knox Village of Central Florida, Inc
• John Knox Village of Central Florida, Inc
• John Knox Village of Central Florida, Inc
• Heather Johns
• Caleigh Johnson
• Roy C Johnson
• Danielle Nicole Jones-Montalvo, PA-C
• Lori S Jones
• Matthew Joseph Jones, HAS
• Jose a Lopez-Cintron MD LLC

• Occupational Therapy Assistant in Orange City, FL
• Providers in Orange City, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.