Glen Thomas Johnson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2118597 Issued in TX

Practice address

311 W Nottingham Dr
San Antonio, TX 78209-1887

Phone

(210) 824-2314

NPI assigned

Feb 18, 2021

Sex

Male

Sole proprietor

No

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": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1346833514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W NOTTINGHAM DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091887",
            "telephone_number": "210-824-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W NOTTINGHAM DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091887",
            "telephone_number": "210-824-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLEN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2118597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Bhateley Johnson, D.D.S.
• Gabriela Nicole Johnson
• Gail Elaine Johnson
• George Edward Johnson
• Georgia Johnson, CCC/SLP
• Gloria J Johnson, PA-C
• Greta Marie Johnson
• Haley Nicole Johnson
• Heather Johnson
• Helen Johnson

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.