Individual provider Active NPI

Glenn Phelps Johnson Jr.

  • Rehabilitation Practitioner
  • Woodland, CA
National Provider Identifier
1710249255
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
137 N Cottonwood St
Suite 1530
Woodland, CA 95695-6646
Phone
(530) 666-9546
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X CA Primary

Addresses

Primary practice location

137 N Cottonwood St
Suite 1530
Woodland, CA 95695-6646

Mailing address

137 N Cottonwood St Ste 1530
Woodland, CA 95695-6664
Phone (530) 666-9546

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

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1710249255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N COTTONWOOD ST STE 1530",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956956664",
            "telephone_number": "530-666-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 N COTTONWOOD ST",
            "address_2": "SUITE 1530",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956956646",
            "telephone_number": "530-666-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLENN",
        "middle_name": "PHELPS",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.