Samantha Odessa Johnson, PT, DPT, ATC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

30213 Issued in AZ

Practice address

707 N Alvernon Way Ste 203
Tucson, AZ 85711-1847

Phone

(520) 462-0235

NPI assigned

Jan 29, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Glendale, AZ
  • NPI 1235654237
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1639700669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 E TANQUE VERDE RD APT 4203",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857497707",
            "telephone_number": "740-497-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N ALVERNON WAY STE 203",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111847",
            "telephone_number": "520-462-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMANTHA",
        "middle_name": "ODESSA",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "30213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Carl Johnson, P.T.
• Ronald Johnson
• Ronald Wayne Johnson, M.D.
• Russell D Johnson
• Ryan Kenji Johnson, M.D.
• Sandra Lee Johnson, ANP
• Sara Rosenfeld Johnson, MS/CCC-SLP
• Sarah Lynne Johnson, OT
• Sean A Johnson, PHARMD
• Shannon Marie Johnson, RN

• Physical Medicine & Rehabilitation Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.