Greg L Johnson, MS, BPS, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A-0767 Issued in NM

Practice address

305 E Miel de Luna Ave
Tucumcari, NM 88401-3810

Phone

(575) 461-7230

NPI assigned

Aug 23, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Dan C. Trigg Memorial Hospital

  • Physical Therapy Clinic/Center
  • Tucumcari, NM
  • NPI 1205253812
  NPD (past)

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

{
    "created_epoch": "1345680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1578811527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201B QUAY ROAD 66",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884019524",
            "telephone_number": "615-618-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E MIEL DE LUNA AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013810",
            "telephone_number": "575-461-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GREG",
        "middle_name": "L",
        "credential": "MS, BPS, PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-23",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-0767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J R McCausland PC
• Rhea Marie Jackson
• James E. Saltz, Jr. M.D. P.a.
• Jina Vick, CNP, PC
• Angela R Johnson, LMHC
• Nicholas Renard Johnson
• Sherri Elaine Johnson, PTA
• Lisa Jones
• Ronald Jones
• Doris A. King, PRESCHOOL TEACHER

• Physical Therapy Assistant in Tucumcari, NM
• Providers in Tucumcari, NM by specialty
• Physical Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; 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.