Individual provider Active NPI

Christopher Evan Johnson, PT, DPT

  • Physical Therapist
  • Patterson, CA
National Provider Identifier
1669148052
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1700 Keystone Pacific Pkwy Unit C2
Patterson, CA 95363-8874
Phone
(209) 881-9274
NPI assigned
Aug 17, 2021
Last updated
Aug 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 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 Primary

Addresses

Primary practice location

1700 Keystone Pacific Pkwy Unit C2
Patterson, CA 95363-8874

Mailing address

PO Box 1305
Sugarloaf, CA 92386-1305
Phone (909) 503-5438

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220106002281 CA Practitioner - Physical Therapist in Private Practice 6103217856 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Fortitude Rehab and Performance Current Accepting new patients
Western Physical Therapy Inc CurrentSince Aug 1, 2022 Accepting new patients
Western Physical Therapy, Inc. Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Mar 7, 2023 Accepting new patients
Western Physical Therapy, Inc. Physical Therapist Current Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Oct 24, 2021 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients

Locations

1516 State Highway 99
Ste G
Gridley, CA 95948
Phone (530) 846-8018

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1700 Keystone Pacific Pkwy
Unit C2
Patterson, CA 95363
Phone (209) 881-9274

1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

116 S Lassen St
Willows, CA 95988
Phone (530) 934-2870

Organizations & group practices 7

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1669148052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1305",
            "city": "SUGARLOAF",
            "state": "CA",
            "postal_code": "923861305",
            "telephone_number": "909-503-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 KEYSTONE PACIFIC PKWY UNIT C2",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953638874",
            "telephone_number": "209-881-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "EVAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patterson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.