Blair Johnson, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

36000299A Issued in IN

Practice address

202 Lincolnway E Ste 100
Mishawaka, IN 46544-2079

Phone

(574) 647-2560

Fax

(574) 647-2563

NPI assigned

Mar 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Health LLCGroup PAC ID 1254690530, 32 clinicians

Practice addresses (Care Compare)

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.

• Beacon Health, LLC

  • Physical Therapist
  • Granger, IN
  • NPI 1386154821
  Medicare reassignment Care Compare group
• Beacon Health, LLC

  • Diagnostic Radiology Physician
  • Goshen, IN
  • NPI 1952982217
  NPD (past)
• Beacon Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • South Bend, IN
  • NPI 1831149525
  NPD (past)

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1538553797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 LINCOLNWAY E STE 100",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442079",
            "telephone_number": "574-647-2560",
            "fax_number": "574-647-2563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 E Ireland Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142845",
            "country_code": "US",
            "telephone_number": "574-647-5790",
            "fax_number": "574-647-5792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E Jackson Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465163513",
            "country_code": "US",
            "telephone_number": "574-389-5558",
            "fax_number": "574-389-5559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 I St Ste 100",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505533",
            "country_code": "US",
            "telephone_number": "219-324-1730",
            "fax_number": "219-324-1735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3221 Beacon Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465307196",
            "country_code": "US",
            "telephone_number": "574-647-2930",
            "fax_number": "574-647-2935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BLAIR",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IN",
            "license": "36000299A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201284010",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjohnson@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1815 E Ireland Rd Ste 100",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466142845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John a. Miller DC PC
• John W. Bulger M.D. P.C.
• Jini Varughese John
• Sunitha A Johns, PHARMD
• Allie Johnson
• Cara M Johnson, NP
• David Michael Johnson, DO
• Dawn Marie Johnson, NP
• Kelsey Johnson
• Kristofer Johnson

• Orthopedic Physical Therapist in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Orthopedic Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.