Individual provider Active NPI

Adrianna Beth Johnson, PT

  • Physical Therapist
  • Ridgeland, MS
National Provider Identifier
1497197529
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2722 Issued in MS
Practice address
950 E County Line Rd Ste a
Ridgeland, MS 39157-1928
Phone
(601) 487-6088
Fax
(601) 487-6068
NPI assigned
Jul 17, 2013
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2722 MS Primary

Addresses

Primary practice location

950 E County Line Rd Ste a
Ridgeland, MS 39157-1928

Mailing address

PO Box 188
Fulton, MS 38843-0188
Phone (662) 862-3070

Other practice location 1

406 Interchange Drive
Fulton, MS 38843
Phone (662) 862-3070

Other practice location 2

1110 S Adams St
Fulton, MS 38843-8952
Phone (662) 862-4104

Other names 1

  • Adrianna B Johnson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140131001741 MS Practitioner - Physical Therapist in Private Practice 3476782038 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT2722MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 22, 2018 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Aug 22, 2018 Accepting new patients
Outpatient Rehabilitation Center of Fulton Inc Physical Therapist CurrentSince Jul 20, 2013 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Aug 22, 2018 Accepting new patients
Fulton Rehabilitation Services, PA PastSince Aug 22, 2018 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

1110 S Adams St
Fulton, MS 38843
Phone (662) 862-4101

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1497197529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "388430188",
            "telephone_number": "662-862-3070",
            "fax_number": "662-862-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE A",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-487-6088",
            "fax_number": "601-487-6068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 INTERCHANGE DRIVE",
            "address_purpose": "LOCATION",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "38843",
            "country_code": "US",
            "telephone_number": "662-862-3070",
            "fax_number": "662-862-4970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1110 S Adams St",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "MS",
            "postal_code": "388438952",
            "country_code": "US",
            "telephone_number": "662-862-4104",
            "fax_number": "662-862-4162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ADRIANNA",
        "middle_name": "BETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT2722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIANNA",
            "last_name": "JOHNSON",
            "middle_name": "B",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.