Individual provider Active NPI

Sara J Johnson, OT

  • Occupational Therapist
  • Dakota Dunes, SD
National Provider Identifier
1407221674
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0726 Issued in SD
Practice address
575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone
(605) 217-2667
Fax
(605) 217-2900
NPI assigned
Dec 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0726 SD Primary
Occupational Therapist 225X00000X 01550 IA

Addresses

Primary practice location

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312

Mailing address

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160128000431 SD Practitioner - Occupational Therapist in Private Practice 4880997626 Reassigns benefits to 1 organization
I20160208001308 IA Practitioner - Occupational Therapist in Private Practice 4880997626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cnos PCGroup PAC ID 4284548942, 98 clinicians

Practice addresses (Care Compare)

2735 Outer Dr N
Cnos Northside
Sioux City, IA 51104-1590
Phone (712) 224-5692

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312
Phone (605) 217-2667

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
82.54
Promoting interoperability
89.05
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cnos, PC CurrentSince Jan 4, 2016 Accepting new patients
Cnos PC CurrentSince Jan 4, 2016 Accepting new patients

Locations

2735 Outer Dr N
Sioux City, IA 51104
Phone (712) 224-5692

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

4802 Sunnybrook Dr
Sioux City, IA 51106
Phone (712) 276-5411

5708 Sunnybrook Ct
Sioux City, IA 51106

575 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-2615

Organizations & group practices 2

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": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1407221674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SARA",
        "middle_name": "J",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SD",
            "license": "0726",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "01550",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dakota Dunes, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.