Individual provider Active NPI

Martha Johnson

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1396014247
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3763-24 Issued in WI
Practice address
2448 S 102ND St
Suite 340
Milwaukee, WI 53227-2466
Phone
(414) 329-2500
NPI assigned
Dec 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3763-24 WI Primary
Physical Therapist 225100000X 070-003218 IL

Addresses

Primary practice location

2448 S 102ND St
Suite 340
Milwaukee, WI 53227-2466

Mailing address

2448 S 102ND St
Suite 340
Milwaukee, WI 53227-2466
Phone (414) 329-2500

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070-003218ILMDPhysical Therapist
3763-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1396014247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST",
            "address_2": "SUITE 340",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532272466",
            "telephone_number": "414-329-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST",
            "address_2": "SUITE 340",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532272466",
            "telephone_number": "414-329-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3763-24",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-003218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.