Active NPI
Michael Johnson, ATC
- Athletic Trainer
- Peninsula, OH
National Provider Identifier
1467822858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 4386
- Practice address
- 4440 Quick Rd
Peninsula, OH 44264-9706 - Phone
- (330) 929-3191
- NPI assigned
- Sep 29, 2015
- Last updated
- Sep 29, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 4386 | OH | Primary |
Addresses
Primary practice location
4440 Quick Rd
Peninsula, OH 44264-9706
Mailing address
215 W Bowery St
Suite 7300
Akron, OH 44308-1069
Phone (330) 543-8260
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4386 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1467822858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 W BOWERY ST",
"address_2": "SUITE 7300",
"city": "AKRON",
"state": "OH",
"postal_code": "443081069",
"telephone_number": "330-543-8260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 QUICK RD",
"city": "PENINSULA",
"state": "OH",
"postal_code": "442649706",
"telephone_number": "330-929-3191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MICHAEL",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-29",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "4386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peninsula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.