Active NPI
Justin Johnson, DPT
- Physical Therapist
- Independence, MO
National Provider Identifier
1710399282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-04820
- Practice address
- 4900 S Arrowhead Dr
Suite B
Independence, MO 64055-6952 - Phone
- (816) 795-6999
- Fax
- (816) 795-3366
- NPI assigned
- Jun 2, 2014
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225100000X | 11-04820 | KS | Primary |
Addresses
Primary practice location
4900 S Arrowhead Dr
Suite B
Independence, MO 64055-6952
Mailing address
4900 S Arrowhead Dr
Suite B
Independence, MO 64055-6952
Phone (816) 795-6999
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-04820 | KS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401667200000",
"number": "1710399282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 S ARROWHEAD DR",
"address_2": "SUITE B",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640556952",
"telephone_number": "816-795-6999",
"fax_number": "816-795-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 S ARROWHEAD DR",
"address_2": "SUITE B",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640556952",
"telephone_number": "816-795-6999",
"fax_number": "816-795-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JUSTIN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-02",
"last_updated": "2014-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-04820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.