NPIMap

Individual provider Active NPI

Carlos R Johnson, DPT

  • Physical Therapist
  • Smyrna, GA
National Provider Identifier
1710381165
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011382 Issued in GA
Practice address
4849 S Cobb Dr SE
Suite 121
Smyrna, GA 30080-7145
Phone
(770) 438-5220
Fax
(770) 438-4367
NPI assigned
Oct 14, 2014
Last updated
Mar 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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 PT011382 GA Primary

Addresses

Primary practice location

4849 S Cobb Dr SE
Suite 121
Smyrna, GA 30080-7145

Mailing address

80 Technacenter Dr
Suite 300
Montgomery, AL 36117-6028
Phone (334) 625-5795

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Occupational Health Centers of Georgia PC Past Accepting new patients
Occupational Health Centers of Georgia PC Past Accepting new patients
PT Solutions of Acworth, LLC Physical Therapist Past Accepting new patients
Occupational Health Centers of Georgia Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1710381165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 TECHNACENTER DR",
            "address_2": "SUITE 300",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361176028",
            "telephone_number": "334-625-5795",
            "fax_number": "334-396-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 S COBB DR SE",
            "address_2": "SUITE 121",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807145",
            "telephone_number": "770-438-5220",
            "fax_number": "770-438-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARLOS",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.