Individual provider Active NPI

Danielle O Johnson, MSPT

  • Physical Therapist
  • Miramar, FL
National Provider Identifier
1366986879
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33037 Issued in FL
Practice address
2637 Pine Tree Dr
Miramar, FL 33023
Phone
(845) 694-7353
NPI assigned
Dec 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Developmental Therapist 222Q00000X 33037 FL
Physical Therapist 225100000X 022018 NY
Physical Therapist 225100000X 33037 FL Primary
Developmental Therapist 222Q00000X 022018 NY

Addresses

Primary practice location

2637 Pine Tree Dr
Miramar, FL 33023

Mailing address

2637 Pine Tree Dr
Miramar, FL 33023-4508
Phone (845) 694-7353

Other names 1

  • Danielle O Champagnie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017000029 FL Practitioner - Physical Therapist in Private Practice 4082966254 Practice locations: Miramar, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33037FLMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1366986879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 PINE TREE DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330234508",
            "telephone_number": "845-694-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 PINE TREE DR",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33023",
            "telephone_number": "845-694-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANIELLE",
        "middle_name": "O",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "33037",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022018",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "33037",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NY",
            "license": "022018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "CHAMPAGNIE",
            "middle_name": "O",
            "credential": "MSPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.