Individual provider Active NPI

La Donna Johns, OTR

  • Physical Medicine & Rehabilitation Physician
  • Warren, MI
National Provider Identifier
1396926622
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5201003531 Issued in MI
Practice address
4600 E 14 Mile Rd
Warren, MI 48092-4369
Phone
(866) 335-3255
Fax
(586) 601-2500
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5201003531 MI Primary

Addresses

Primary practice location

4600 E 14 Mile Rd
Warren, MI 48092-4369

Mailing address

4600 E 14 Mile Rd
Warren, MI 48092-4369
Phone (866) 335-3255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100429000684 NJ Practitioner - Occupational Therapist in Private Practice 0042393282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Group practices
Activa Rehabilitation Services LLCGroup PAC ID 2466693163, 2 clinicians

Practice addresses (Care Compare)

331 Central Ave
Suite 1
Orange, NJ 07050-2407
Phone (973) 673-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201003531MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Activa Rehabilitation Services LLC CurrentSince Apr 13, 2024 Accepting new patients

Locations

331 Central Ave
#1
Orange, NJ 07050
Phone (973) 673-4600

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": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1396926622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 E 14 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924369",
            "telephone_number": "866-335-3255",
            "fax_number": "586-601-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 E 14 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924369",
            "telephone_number": "866-335-3255",
            "fax_number": "586-601-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "LA DONNA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5201003531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.