Jeffery Kent Johnson, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT3431 Issued in TX

Practice address

4141 Spring Valley Rd
Addison, TX 75001-3615

Phone

(972) 628-5649

Fax

(972) 628-5650

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326008376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 SPRING VALLEY RD",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013615",
            "telephone_number": "972-628-5649",
            "fax_number": "972-628-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 SPRING VALLEY RD",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013615",
            "telephone_number": "972-628-5649",
            "fax_number": "972-628-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFERY",
        "middle_name": "KENT",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT3431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Locuson LCSW PLLC
• Jim Savage Consulting
• Gina Jimenez
• Anna Johnson
• Claire Johnson, OTR
• Natalie C Johnson, MS, LMFT-A, LCDC-I
• Madeline Claire Johnston, D.C.
• Melissa Ann Johnston, PA-C
• Taylor Nicole Johnston, M.S. CF-SLP
• Lacee Jones Nichols

• Athletic Trainer in Addison, TX
• Providers in Addison, TX by specialty
• Athletic Trainer in Texas

• 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.