Shirley Mae Johnson, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00002003 Issued in WA

Practice address

1500 3Rd Ave
Longview, WA 98632-3229

Phone

(360) 423-8800

NPI assigned

Jun 24, 2008

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

State licenses

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1487815262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7508 OLD PACIFIC HWY N",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986118925",
            "telephone_number": "360-274-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 3RD AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323229",
            "telephone_number": "360-423-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHIRLEY",
        "middle_name": "MAE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002003",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2149",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Mark Johnson, PHARM.D.
• Nicole Renee Johnson
• Pyper Johnson
• Rachel L Johnson, SUDPT
• Reid Johnson, CCC-SLP
• Tammy L Johnson, OPTICIAN
• Valerie Johnson, BA, R-AAC
• Cassidy Johnston
• John M Johnston, AAC
• Linda K. Johnston, ARNP

• Physical Therapist in Longview, WA
• Providers in Longview, WA by specialty
• Physical Therapist in Washington

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