Calyn Nicole Johnson, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2667 Issued in OK

Practice address

1200 E Pecan St
Altus, OK 73521-6141

Phone

(580) 379-5820

Fax

(580) 379-5829

NPI assigned

Nov 1, 2016

Last updated

Oct 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: calynjohnson@direct.jcmh.com

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.

• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1407308935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14425 N 2320 RD",
            "city": "GOTEBO",
            "state": "OK",
            "postal_code": "730416708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5820",
            "fax_number": "580-379-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CALYN",
        "middle_name": "NICOLE",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201092420A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CalynJohnson@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "1200 E Pecan St",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735216141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• JCMH Healthcare Corporation (JCMH Scanner)
• JCMH Home Health Products Inc. (Home Health Products)
• Danielle Jensen, R.D./L.D.
• Jim Taliaferro CMHC
• Morgan Paige Johns, APRN-CNS
• Brandi Sue Jones, LPTA
• Julie Ann Josey
• Dana Juarez, MA, LMFT
• Shayla Nicole Kadow
• Liladhar Kashyap, MD

• Physical Therapy Assistant in Altus, OK
• Providers in Altus, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.