Individual provider Active NPI

Trevor Dillon Johnson

  • Physical Therapist
  • Overland Park, KS
National Provider Identifier
1427652023
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P19998 Issued in NC
Practice address
6901 Shawnee Mission Pkwy Ste 207
Overland Park, KS 66202-4082
Phone
(888) 913-1910
NPI assigned
Nov 24, 2020
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P19998 NC Primary

Addresses

Primary practice location

6901 Shawnee Mission Pkwy Ste 207
Overland Park, KS 66202-4082

Mailing address

1310 Iris Dr Apt 1114
Charlotte, NC 28205-6083
Phone (516) 458-0081

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127001663 NC Practitioner - Physical Therapist in Private Practice 1456765700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

167 Cross Ctr Rd
Denver, NC 28037-5009
Phone (704) 951-8320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy and Hand Specialist, LLC CurrentSince Sep 20, 2021 Accepting new patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist CurrentSince Sep 20, 2021 Accepting new patients
Physical Therapy and Hand Specialists, LLC Physical Therapist CurrentSince Sep 20, 2021 Accepting new patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Sep 20, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

167 Cross Center Rd
Denver, NC 28037
Phone (704) 951-8320

207 E Meadow Rd
Ste 3
Eden, NC 27288
Phone (336) 627-3771

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1427652023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 IRIS DR APT 1114",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056083",
            "telephone_number": "516-458-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 SHAWNEE MISSION PKWY STE 207",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662024082",
            "telephone_number": "888-913-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TREVOR",
        "middle_name": "DILLON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.