Individual provider Active NPI

Karen A Johnson, P.T.

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1558403667
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19738 Issued in MD
Practice address
9159 Red Branch Rd # F
Columbia, MD 21045-2013
Phone
(410) 740-2155
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 19738 MD Primary

Addresses

Primary practice location

9159 Red Branch Rd # F
Columbia, MD 21045-2013

Mailing address

PO Box 874
Columbia, MD 21044-0874
Phone (410) 740-2155

Other identifiers 1

IdentifierTypeStateIssuer
LS82OtherMDBLUECROSSBLUESHIEL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050603000585 MD Practitioner - Physical Therapist in Private Practice 5193768810 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19738MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Integrated Manual Therapies LLC Physical Therapist CurrentSince Mar 27, 2000 Accepting new patients

Locations

9159 Red Branch Rd
Ste F
Columbia, MD 21045
Phone (301) 887-5689

10716 Little Patuxent Pkwy
#210
Columbia, MD 21044
Phone (301) 490-0165

9130 Red Branch Rd
Ste F
Columbia, MD 21045
Phone (410) 740-2155

Organizations & group practices 1

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558403667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 874",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210440874",
            "telephone_number": "410-740-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9159 RED BRANCH RD # F",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452013",
            "telephone_number": "410-740-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAREN",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIEL",
            "identifier": "LS82",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.