Active NPI
Danielle O Johnson, MSPT
- Physical Therapist
- Miramar, FL
National Provider Identifier
1366986879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 33037
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 33037 | FL | MD | Developmental 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.