Individual provider Active NPI

Katharine Lackman Johnson, PT

  • Pediatric Physical Therapist
  • Doylestown, PA
National Provider Identifier
1457486953
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT001220E Issued in PA
Practice address
705 N Shady Retreat Rd
Doylestown, PA 18901-2507
Phone
(800) 770-4822
Fax
(215) 658-0959
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT001220E PA Primary

Addresses

Primary practice location

705 N Shady Retreat Rd
Doylestown, PA 18901-2507

Mailing address

1801 Willow Ave
Willow Grove, PA 19090-3705
Phone (215) 658-0959

Other names 1

  • Katharine Louise Lackman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT001220EPAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1457486953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WILLOW AVE",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190903705",
            "telephone_number": "215-658-0959",
            "fax_number": "215-658-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N SHADY RETREAT RD",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012507",
            "telephone_number": "800-770-4822",
            "fax_number": "215-658-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHARINE",
        "middle_name": "LACKMAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "PA",
            "license": "PT001220E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHARINE",
            "last_name": "LACKMAN",
            "middle_name": "LOUISE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.