Individual provider Active NPI

Michael S. Johnston, M.S.P.T.

  • Physical Therapist
  • Frederick, MD
National Provider Identifier
1679691075
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17254 Issued in MD
Practice address
187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503
Phone
(301) 663-1157
Fax
(301) 663-1229
NPI assigned
Mar 26, 2007
Last updated
Jun 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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 17254 MD Primary

Addresses

Primary practice location

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

Mailing address

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503
Phone (301) 663-1157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125000860 MD Practitioner - Physical Therapist in Private Practice 7214941517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17254MDMDPhysical Therapist

Organizations & group practices 1

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1679691075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 THOMAS JOHNSON DR",
            "address_2": "SUITE 6",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024503",
            "telephone_number": "301-663-1157",
            "fax_number": "301-663-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 THOMAS JOHNSON DR",
            "address_2": "SUITE 6",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024503",
            "telephone_number": "301-663-1157",
            "fax_number": "301-663-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.