Individual provider Active NPI

Danielle Marie Johnson, PT

  • Physical Therapist
  • North Royalton, OH
National Provider Identifier
1710156591
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011749 Issued in OH
Practice address
5340 Royalton Rd
North Royalton, OH 44133-4008
Phone
(440) 230-1133
Fax
(440) 230-9243
NPI assigned
Feb 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 011749 OH Primary

Addresses

Primary practice location

5340 Royalton Rd
North Royalton, OH 44133-4008

Mailing address

5340 Royalton Rd
PO Box 33396
North Royalton, OH 44133-4008
Phone (440) 230-1133

Other identifiers 1

IdentifierTypeStateIssuer
011749OtherOHOHIO LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080508000326 OH Practitioner - Physical Therapist in Private Practice 6305925835 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011749OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tricounty Physical Therapy Physical Therapist Past Accepting new patients
Crystal Clinic Inc Past Accepting new patients
Crystal Clinic, Inc. Past Accepting new patients
Tricounty Physical Therapy Inc Physical Therapist Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1710156591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 ROYALTON RD",
            "address_2": "PO BOX 33396",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334008",
            "telephone_number": "440-230-1133",
            "fax_number": "440-230-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 ROYALTON RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334008",
            "telephone_number": "440-230-1133",
            "fax_number": "440-230-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "011749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "011749",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Royalton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.