Individual provider Active NPI

Madison Tinker- Johnson, DPT

  • Physical Therapist
  • Cheyenne, WY
National Provider Identifier
1619718210
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-2408 Issued in WY
Practice address
1331 Prairie Ave Ste 6
Cheyenne, WY 82009-4867
Phone
(307) 637-4617
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 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 PT-2408 WY Primary

Addresses

Primary practice location

1331 Prairie Ave Ste 6
Cheyenne, WY 82009-4867

Mailing address

1331 Prairie Ave Ste 6
Cheyenne, WY 82009-4867

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820004327 WY Practitioner - Physical Therapist in Private Practice 3971041062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blair Investments IncGroup PAC ID 9234161035, 20 clinicians

Practice addresses (Care Compare)

4020 Laramie St
Cheyenne, WY 82001-2064
Phone (307) 637-4617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2408WYMDPharmacist
PT-2408WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blair Investments Inc Physical Therapist CurrentSince Jun 11, 2024 Accepting new patients

Locations

1541 Centennial Ct
Casper, WY 82609
Phone 30723539104151

4020 Laramie St
Cheyenne, WY 82001
Phone (307) 637-4617

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": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1619718210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 PRAIRIE AVE STE 6",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 PRAIRIE AVE STE 6",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094867",
            "telephone_number": "307-637-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINKER- JOHNSON",
        "first_name": "MADISON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-2408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.