Marilyn Elizabeth Johnson, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA000333 Issued in FL

Practice address

2525 SW 75 Avenue
Miami, FL 33155

Phone

(305) 260-1842

Fax

(304) 267-1841

NPI assigned

Apr 7, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marilyn Elizabeth Van de Bogart Former name

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1700175072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 LISBON STREET",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342223",
            "telephone_number": "305-774-9183",
            "fax_number": "305-774-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 SW 75 AVENUE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33155",
            "telephone_number": "305-260-1842",
            "fax_number": "304-267-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARILYN",
        "middle_name": "ELIZABETH",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA000333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "VAN DE BOGART",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lashea Monet Johnson, MD
• Latrise Martell Johnson
• Lauren Lee Johnson
• Makayla Johnson, PT, DPT
• Marcia Maria Johnson, AGPCNP, MSN, RN, OCN
• Mel Paul Johnson, PSYDR, RN, ARNP
• Paul M. Johnson
• Penelope Johnson, BCBA
• Perry Barnett Johnson, PHD
• Phyllis Michelle Johnson

• Physical Therapy Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.