Individual provider Active NPI

Marcus Paul Johnson, DPT

  • Physical Therapist
  • Sioux City, IA
National Provider Identifier
1558094896
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
112333 Issued in IA
Practice address
3100 S Lakeport St
Sioux City, IA 51106-4222
Phone
(712) 277-4442
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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 112333 IA Primary

Addresses

Primary practice location

3100 S Lakeport St
Sioux City, IA 51106-4222

Mailing address

3100 S Lakeport St
Sioux City, IA 51106-4222
Phone (515) 204-8410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251027001694 IA Practitioner - Physical Therapist in Private Practice 9931698487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Therapy Services LLCGroup PAC ID 9335360130, 10 clinicians

Practice addresses (Care Compare)

1515 Linden St
Suite 101
Des Moines, IA 50309-3120
Phone (515) 288-0569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112333IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy Services LLC Physical Therapist CurrentSince Nov 10, 2025 Accepting new patients
HS Occupational Wellness LLC Physical Therapist PastSince Dec 21, 2025 Accepting new patients

Locations

6151 Thornton Ave
Ste 300
Des Moines, IA 50321
Phone (515) 288-0569

1515 Linden St
Ste 101
Des Moines, IA 50309
Phone (515) 288-0569

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1558094896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 S LAKEPORT ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064222",
            "telephone_number": "515-204-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S LAKEPORT ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064222",
            "telephone_number": "712-277-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARCUS",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "112333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.