Bradley Zenor Johnson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14156 Issued in WI

Practice address

1190 E Paradise Dr
West Bend, WI 53095

Phone

(262) 306-6319

NPI assigned

May 23, 2018

Sex

Male

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)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Johnson Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • West Hartford, CT
  • NPI 1770268518
  NPD Authorized official

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1487145579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 BLUFFVIEW CT",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011512",
            "telephone_number": "608-617-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "53095",
            "telephone_number": "262-306-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "ZENOR",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "1415624",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Suzanne Janssen, M.S. CCC-SLP
• Renee M Janusz, CSAC
• Hollister L Jefferson, M.A., SAC-IT
• Katie Ann Jensen, M.A./CFY-SLP
• Keyonta Latrise Johnson- Sims
• Courtney Eileen Johnson
• Jennifer Sue Johnson, LPC
• Lisa L Johnson, P.T.A.
• Mary Johnson, PT
• Matthew Johnson, LPC, SAC-IT

• Physical Therapist in West Bend, WI
• Providers in West Bend, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.