Individual provider Active NPI

Laurie Johnson, PT

  • Physical Therapist
  • Norfolk, VA
National Provider Identifier
1720061351
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305003714 Issued in VA
Practice address
5665 Lowery Rd
#300
Norfolk, VA 23502-2220
Phone
(757) 351-6020
Fax
(757) 351-6021
NPI assigned
Nov 29, 2005
Last updated
Oct 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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 2305003714 VA Primary

Addresses

Primary practice location

5665 Lowery Rd
#300
Norfolk, VA 23502-2220

Mailing address

PO Box 5982
Virginia Beach, VA 23471-0982
Phone (757) 351-6020

Other identifiers 6

IdentifierTypeStateIssuer
008938741MedicaidVA
010380740MedicaidVA
010381207MedicaidVA
010381223MedicaidVA
010380758MedicaidVA
010380766MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101109001071 VA Practitioner - Physical Therapist in Private Practice 2365637998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Massachusetts Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Therapy Network IncGroup PAC ID 3072562933, 12 clinicians

Practice addresses (Care Compare)

637 Kingsborough SQ
Suite F
Chesapeake, VA 23320-4944
Phone (757) 547-7554

Merit-based Incentive Payment System (MIPS)

Final score
72.99 of 100Reported as group
Quality
66.22
Improvement activities
40
Cost
55.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305003714VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Network Inc Physical Therapist CurrentSince Aug 23, 1994 Accepting new patients
Center for Work Recovery Physical Therapist Past Accepting new patients
Walko Enterprise Incorporated Past Accepting new patients

Locations

637 Kingsborough Sq
Ste F
Chesapeake, VA 23320
Phone (757) 547-7554

5665 Lowery Rd
Ste 300
Norfolk, VA 23502
Phone (757) 351-6020

1444 Kempsville Rd
Virginia Beach, VA 23464
Phone (757) 474-7490

1450 Kempsville Rd
Ste 102
Virginia Beach, VA 23464
Phone (757) 455-8300

762 Independence Blvd
Ste 772
Virginia Beach, VA 23455
Phone (757) 456-2032

Organizations & group practices 3

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1720061351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5982",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234710982",
            "telephone_number": "757-351-6020",
            "fax_number": "757-351-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 LOWERY RD",
            "address_2": "#300",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022220",
            "telephone_number": "757-351-6020",
            "fax_number": "757-351-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAURIE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305003714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008938741",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010380740",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010381207",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010381223",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010380758",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010380766",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.