Glen Johnson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00245400 Issued in NJ

Practice address

231 Warner St
Toms River, NJ 08755-1028

Phone

(732) 942-0800

NPI assigned

Nov 28, 2015

Last updated

Nov 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1448668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448668800000",
    "number": "1699149831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 WARNER ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551028",
            "telephone_number": "732-942-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 WARNER ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551028",
            "telephone_number": "732-942-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLEN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-28",
        "last_updated": "2015-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00245400",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "3876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi B Kidz LLC
• Thomas J Joe, D.C.
• Richard Joffe Jr., LCSW
• John J Vaccaro MD P a
• John P Sersanti, MD,PC
• Lauren Marie Johnson, P.A.C.
• Matthew Johnson, DPT
• Natalie Adele Johnson, PT
• Jomi Partners LLC
• Andrulisa Jones, MD

• Physical Therapy Assistant in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2015; 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.