Individual provider Active NPI

Tracie M Johnson, PHYSICAL THERAPIST

  • Physical Therapist
  • Cary, NC
National Provider Identifier
1639368756
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P11704 Issued in NC
Practice address
201 W Chatham St Ste 208
Cary, NC 27511-3290
Phone
(919) 973-8827
Fax
(919) 981-9075
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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 P11704 NC Primary

Addresses

Primary practice location

201 W Chatham St Ste 208
Cary, NC 27511-3290

Mailing address

201 W Chatham St Ste 208
Cary, NC 27511-3290
Phone (919) 973-8827

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260413001341 NC Practitioner - Physical Therapist in Private Practice 9436249984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Michigan Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elevation Rehab, LLCGroup PAC ID 2062814106, 15 clinicians

Practice addresses (Care Compare)

3420 Wake Forest Hwy
Durham, NC 27703-3522
Phone (919) 823-1606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P11704NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy Associates LLC Physical Therapist Past Accepting new patients
Global Health Metrics, LLC Physical Therapist Past Accepting new patients
Transitional Steps Pediatric Physical Therapy Physical Therapist PastSince Feb 18, 2024 Accepting new patients
Tranquility Home Health Care, LLC Physical Therapist PastSince Nov 6, 2007 Accepting new patients

Organizations & group practices 5

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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1639368756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W CHATHAM ST STE 208",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275113290",
            "telephone_number": "919-973-8827",
            "fax_number": "919-981-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W CHATHAM ST STE 208",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275113290",
            "telephone_number": "919-973-8827",
            "fax_number": "919-981-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TRACIE",
        "middle_name": "M",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P11704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.