Individual provider Active NPI

Julie Ann Johnson, DPT

  • Physical Therapist
  • Grand Rapids, MI
National Provider Identifier
1659733376
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305213378 Issued in VA
Practice address
5060 Cascade Rd SE Ste a
Grand Rapids, MI 49546-3808
Phone
(616) 954-0950
NPI assigned
Mar 22, 2016
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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 2305213378 VA Primary

Addresses

Primary practice location

5060 Cascade Rd SE Ste a
Grand Rapids, MI 49546-3808

Mailing address

5060 Cascade Rd SE Ste a
Grand Rapids, MI 49546-3808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305213378VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Primus Physical Therapy Fairfax Physical Therapist CurrentSince Jul 6, 2021 Accepting new patients
Center for Physical Rehabilitation Inc Physical Therapist PastSince May 9, 2018 Accepting new patients

Locations

6101 Redwood Square Ctr
Ste 202
Centreville, VA 20121
Phone (703) 543-6660

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1659733376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 CASCADE RD SE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 CASCADE RD SE STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463808",
            "telephone_number": "616-954-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.