Individual provider Active NPI

Charles Toshimichi Johansen

  • Physical Therapist
  • Thousand Oaks, CA
National Provider Identifier
1568010718
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297265 Issued in CA
Practice address
2166 N Moorpark Rd Ste 200
Thousand Oaks, CA 91360-5011
Phone
(805) 370-1020
Fax
(805) 370-1022
NPI assigned
Aug 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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 297265 CA Primary

Addresses

Primary practice location

2166 N Moorpark Rd Ste 200
Thousand Oaks, CA 91360-5011

Mailing address

2166 N Moorpark Rd Ste 200
Thousand Oaks, CA 91360-5011
Phone (805) 370-1020

Other practice location 1

1248 S Broadway
Denver, CO 80210-1504
Phone (720) 699-9095

Other practice location 2

6235 S Main St Ste C-101
Aurora, CO 80016-5373
Phone (303) 344-9090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250521003287 CO Practitioner - Physical Therapist in Private Practice 4789914821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1248 S Broadway
Denver, CO 80210-1504
Phone (720) 699-9095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Centers of Colorado, LLC Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
Bartley Physical Therapy PC Physical Therapist CurrentSince Aug 23, 2019 Accepting new patients
Orthopedic Centers of Colorado, LLC Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients

Locations

2166 N Moorpark Rd
Ste 200
Thousand Oaks, CA 91360
Phone (805) 370-1020

6235 S Main St
Ste C101
Aurora, CO 80016

1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134

6235 S Main St
Ste 101
Aurora, CO 80016
Phone (303) 785-7928

1248 S Broadway
Denver, CO 80210
Phone (720) 699-9095

8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998

Organizations & group practices 3

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": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1568010718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2166 N MOORPARK RD STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605011",
            "telephone_number": "805-370-1020",
            "fax_number": "805-370-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2166 N MOORPARK RD STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605011",
            "telephone_number": "805-370-1020",
            "fax_number": "805-370-1022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1248 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802101504",
            "country_code": "US",
            "telephone_number": "720-699-9095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6235 S Main St Ste C-101",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800165373",
            "country_code": "US",
            "telephone_number": "303-344-9090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "CHARLES",
        "middle_name": "TOSHIMICHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-30",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.