Individual provider Active NPI

Thomas L Johnson, PT

  • Physical Therapist
  • Jackson, TN
National Provider Identifier
1629135264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1726 Issued in TN
Practice address
24 Physicians Dr
Jackson, TN 38305
Phone
(731) 661-9825
Fax
(731) 668-6757
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT1726 TN Primary

Addresses

Primary practice location

24 Physicians Dr
Jackson, TN 38305

Mailing address

24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825

Other identifiers 1

IdentifierTypeStateIssuer
3375781MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080811000199 TN Practitioner - Physical Therapist in Private Practice 2264506187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Bone and Joint Clinic PCGroup PAC ID 7517940182, 64 clinicians

Practice addresses (Care Compare)

50 Capital Ave
Jackson, TN 38305-5507
Phone (731) 661-9825

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Promoting interoperability
98
Improvement activities
40
Cost
73.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1726TNMDProfessional Counselor
PT1726TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Bone and Joint Clinic PC Physical Therapist CurrentSince Feb 18, 2010 Accepting new patients

Locations

24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825

50 Capital Ave
Jackson, TN 38305
Phone (731) 661-9825

Interoperability endpoints

  • Direct secure messaging: thomas.johnson.1@3533.direct.athenahealth.com

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629135264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT1726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3375781",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.