Jennifer Johnson

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

12825 Minnieville Rd Ste 201
Lake Ridge, VA 22192-3602

Phone

(571) 470-8776

NPI assigned

Sep 4, 2007

Last updated

Jul 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1740474675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12825 MINNIEVILLE RD STE 201",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923602",
            "telephone_number": "571-470-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12825 MINNIEVILLE RD STE 201",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923602",
            "telephone_number": "571-470-8776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3025 Hamaker Ct Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220312221",
            "country_code": "US",
            "telephone_number": "703-560-5548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Caroline Guerrero
• Courtney Hall
• Meredith Hill, RDN
• Ramin Ipakchi, MD
• Gilissa Johnson
• Rachita Kenny, CNS
• Riken Kumar, MD
• Lawrence R. Muller, DDS, PC
• Alison L Liudahl, AU.D.,C.C.C.-A,F.A.A
• Logan Denise Luke, OTR/L

• Physical Therapy Assistant in Lake Ridge, VA
• Providers in Lake Ridge, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.