Active NPI
Jeanna M Johnson
- Physical Therapy Assistant
- Phoenix, AZ
National Provider Identifier
1700076718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 041-0000312
- Practice address
- 7540 N 19TH Ave
Suite200
Phoenix, AZ 85021-7967 - Phone
- (888) 873-4221
- NPI assigned
- Jul 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 041-0000312 | VT | Primary |
Addresses
Primary practice location
7540 N 19TH Ave
Suite200
Phoenix, AZ 85021-7967
Mailing address
922 Gates Pond Rd
PO Box 991
Jacksonville, VT 05342-9607
Phone (802) 368-7116
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-0000312 | VT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1700076718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "922 GATES POND RD",
"address_2": "PO BOX 991",
"city": "JACKSONVILLE",
"state": "VT",
"postal_code": "053429607",
"telephone_number": "802-368-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7540 N 19TH AVE",
"address_2": "SUITE200",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850217967",
"telephone_number": "888-873-4221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JEANNA",
"middle_name": "M",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-26",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VT",
"license": "041-0000312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.