Active NPI
Marcus Paul Johnson, DPT
- Physical Therapist
- Sioux City, IA
National Provider Identifier
1558094896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 112333
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 112333 | IA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Therapy Services LLC | Physical Therapist | Current | Accepting new patients |
| HS Occupational Wellness LLC | Physical Therapist | Past | 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.
-
- Physical Therapist
- Des Moines, IA
- NPI 1730597030
-
- Physical Therapist
- Sioux City, IA
- NPI 1982202180
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.