Active NPI
Drew Elizabeth Johnson, ATC
- Athletic Trainer
- East Stroudsburg, PA
National Provider Identifier
1588899728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT004540
- Practice address
- 400 E Brown St
Apartment 811
East Stroudsburg, PA 18301-7807 - Phone
- (616) 262-2028
- NPI assigned
- May 18, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT004540 | PA | Primary |
Addresses
Primary practice location
400 E Brown St
Apartment 811
East Stroudsburg, PA 18301-7807
Mailing address
2275 20 Mile Rd
P.O. Box 54
Kent City, MI 49330-9492
Phone (616) 262-2028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT004540 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242604800000",
"number": "1588899728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2275 20 MILE RD",
"address_2": "P.O. BOX 54",
"city": "KENT CITY",
"state": "MI",
"postal_code": "493309492",
"telephone_number": "616-262-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E BROWN ST",
"address_2": "APARTMENT 811",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183017807",
"telephone_number": "616-262-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DREW",
"middle_name": "ELIZABETH",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-18",
"last_updated": "2009-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT004540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Stroudsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.