Theresa F Johnson, OT

Individual provider Active NPI Occupational Therapist · Urbandale, IA

NPI 1619066552 · NPPES record last updated Nov 2, 2022

Key facts

NPI
1619066552
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
01170 (IA)
Practice address
4319 NW Urbandale Dr
Urbandale, IA 50322-7910
Phone
(515) 225-4070
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
01170IAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Stone Therapy Inc. Current Accepting new patients
Blue Stone Therapy Inc. Current Accepting new patients

Locations

4319 NW Urbandale Dr
Urbandale, IA 50322
Phone (515) 875-9470

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 01170 IA Yes

Addresses

Primary practice location

4319 NW Urbandale Dr
Urbandale, IA 50322-7910

Mailing address

4319 NW Urbandale Dr
Urbandale, IA 50322-7910
Phone (515) 225-4070

Other providers in Urbandale, IA

All providers in Urbandale, IA · Occupational Therapist in Iowa

Sources for this page

Verify at the official NPI Registry.