Active NPI
Joan M Johnson, OT
- Occupational Therapist
- Tualatin, OR
National Provider Identifier
1376873455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1069889
- Practice address
- 19250 SW 65TH Ave
Medical Plaza, Suite 125
Tualatin, OR 97062-7452 - Phone
- (503) 692-1817
- Fax
- (503) 692-1669
- NPI assigned
- Jan 12, 2010
- 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 | 1069889 | OR | Primary |
Addresses
Primary practice location
19250 SW 65TH Ave
Medical Plaza, Suite 125
Tualatin, OR 97062-7452
Mailing address
PO Box 4037
Portland, OR 97208-4037
Phone (503) 413-4048
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 |
|---|---|---|---|
| Beyond the Clinic PC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291075200000",
"number": "1376873455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4037",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084037",
"telephone_number": "503-413-4048",
"fax_number": "503-413-2910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19250 SW 65TH AVE",
"address_2": "MEDICAL PLAZA, SUITE 125",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627452",
"telephone_number": "503-692-1817",
"fax_number": "503-692-1669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOAN",
"middle_name": "M",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-12",
"last_updated": "2010-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "1069889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.