Individual provider Active NPI

Jennifer Ann Johnson, PT, DPT

  • Physical Therapist
  • Brenham, TX
National Provider Identifier
1619778024
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1218137 Issued in TX
Practice address
100 Trinity St
Brenham, TX 77833-5536
Phone
(808) 223-6071
NPI assigned
Mar 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 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 1218137 TX Primary

Addresses

Primary practice location

100 Trinity St
Brenham, TX 77833-5536

Mailing address

100 Trinity St
Brenham, TX 77833-5536
Phone (808) 223-6071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250506002059 TX Practitioner - Physical Therapist in Private Practice 0941727606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

6336 Woodway Dr
Houston, TX 77057-1750
Phone (713) 423-6066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1218137TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast, LLC Physical Therapist CurrentSince Mar 2, 2025 Accepting new patients

Locations

127 W Broad St
Ste 850
Lake Charles, LA 70601
Phone (337) 310-8500

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": "1742515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1619778024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TRINITY ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335536",
            "telephone_number": "808-223-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TRINITY ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335536",
            "telephone_number": "808-223-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1218137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

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