Active NPI
Crystal Leighann Johnson, OT
- Occupational Therapist
- Paris, TN
National Provider Identifier
1376655639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3643
- Practice address
- 109 Commerce St
Paris, TN 38242-4917 - Phone
- (731) 641-8111
- Fax
- (731) 641-8110
- NPI assigned
- Aug 31, 2006
- Last updated
- Sep 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3643 | TN | Primary |
Addresses
Primary practice location
109 Commerce St
Paris, TN 38242-4917
Mailing address
PO Box 739
Dover, TN 37058-0739
Phone (731) 641-8111
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00103288 | Other | TN | PALMETTO GBA RR MEDICARE |
| 12115 | Other | VA | |
| 33297 | Other | TN | TLC |
| 3729568 | Medicaid | TN | |
| 4158884 | Other | TN | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Campbell Therapy Center LLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221782400000",
"number": "1376655639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 739",
"city": "DOVER",
"state": "TN",
"postal_code": "370580739",
"telephone_number": "731-641-8111",
"fax_number": "731-641-8110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 COMMERCE ST",
"city": "PARIS",
"state": "TN",
"postal_code": "382424917",
"telephone_number": "731-641-8111",
"fax_number": "731-641-8110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CRYSTAL",
"middle_name": "LEIGHANN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2008-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "3643",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA RR MEDICARE",
"identifier": "P00103288",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA",
"identifier": "12115",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TLC",
"identifier": "33297",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3729568",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4158884",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paris, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.