Rebecca Karen Johnston, P.T.
Individual provider Active NPI Physical Therapist · Gray, TN
NPI 1659611176 · NPPES record last updated Feb 20, 2013
Key facts
- NPI
- 1659611176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 9490 (TN)
- Practice address
- 406 Roy Martin Rd
Gray, TN 37615-2244 - Phone
- (423) 477-1101
- Fax
- (423) 477-1102
- NPI assigned
- Feb 20, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9490 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Achieve Health and Wellness | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9490 | TN | Yes |
Addresses
Primary practice location
406 Roy Martin Rd
Gray, TN 37615-2244
Mailing address
406 Roy Martin Rd
Gray, TN 37615-2244
Other providers in Gray, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.