Individual provider Active NPI

Richard Lee Johnson, P.T.A.

  • Physical Therapy Assistant
  • Chandler, AZ
National Provider Identifier
1740455377
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
7885A Issued in AZ
Practice address
655 S Dobson Rd BLDG B
Suite #111
Chandler, AZ 85224-5667
Phone
(480) 732-0099
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 7885A AZ Primary

Addresses

Primary practice location

655 S Dobson Rd BLDG B
Suite #111
Chandler, AZ 85224-5667

Mailing address

655 S Dobson Rd BLDG B
Suite #111
Chandler, AZ 85224-5667
Phone (480) 732-0099

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

State licenses

LicenseStateTypeSpecialty
7885AAZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1740455377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S DOBSON RD BLDG B",
            "address_2": "SUITE #111",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245667",
            "telephone_number": "480-732-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S DOBSON RD BLDG B",
            "address_2": "SUITE #111",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245667",
            "telephone_number": "480-732-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "7885A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.