Michelle Johnston

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2119972 Issued in TX

Practice address

1206 N Travis St
Liberty, TX 77575-3540

Phone

(979) 820-1775

NPI assigned

Feb 8, 2022

Last updated

Feb 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1548914567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15316 HUMMINGBIRD ST",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775239660",
            "telephone_number": "979-820-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N TRAVIS ST",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775753540",
            "telephone_number": "979-820-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2119972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "optima",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR",
            "address_1": "1206 N Travis St",
            "city": "Liberty",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775753540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hull Daisetta Isd
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• Johnson Patient-Care Supplies Inc
• Sekinat Olubukunola Kekere-Ekun, PHARMD
• Katie Kellner
• Danny Kyaw Khine, MD
• Carissa Kathryn Kruckemeyer, PHARMD
• Jennifer Landaverde

• Physical Therapy Assistant in Liberty, TX
• Providers in Liberty, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.