Individual provider Active NPI

Julie B Johnson, PHYSICAL THERAPIST

  • Physical Therapist
  • Jackson, GA
National Provider Identifier
1508918939
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006803 Issued in GA
Practice address
1050 McDonough Rd
Jackson, GA 30233-1524
Phone
(770) 775-7861
Fax
(770) 775-6263
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 PT006803 GA Primary

Addresses

Primary practice location

1050 McDonough Rd
Jackson, GA 30233-1524

Mailing address

1050 McDonough Rd
Jackson, GA 30233-1524
Phone (770) 775-7861

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
PT006803GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508918939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 MCDONOUGH RD",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331524",
            "telephone_number": "770-775-7861",
            "fax_number": "770-775-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MCDONOUGH RD",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331524",
            "telephone_number": "770-775-7861",
            "fax_number": "770-775-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JULIE",
        "middle_name": "B",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.