Lyllie Christine MC Bride Johnson, MS, LAT, ATC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

6676 Issued in FL

Practice address

13837 Circa Crossing Dr
Lithia, FL 33547-4382

Phone

(203) 733-6035

NPI assigned

Jun 21, 2022

Last updated

Apr 9, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1437880325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3384 SUNCOAST PLAINS DR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335562935",
            "telephone_number": "203-733-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13837 CIRCA CROSSING DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474382",
            "telephone_number": "203-733-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LYLLIE",
        "middle_name": "CHRISTINE MC BRIDE",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "6676",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "2000051414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Johnsey
• Emily Jane Johnson-Day, DO
• Brittney Johnson
• Carissa Johnson, M.S., C.C.C.
• Joel Johnson, FNP-C
• Marc Roy Johnson, DMD
• Morgan Johnson, FNP-C
• Riley Johnson
• Sharon J. Johnson, M.S.
• James Russell Jones, LMHC

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Lithia, FL
• Providers in Lithia, FL by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.