Gaynor Jacqueline Johansen

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

129441 Issued in AK

Practice address

7731 E Northern Lights Blvd Ste 2
Anchorage, AK 99504-3572

Phone

(907) 245-5555

Fax

(907) 333-5755

NPI assigned

Mar 6, 2018

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

State licenses

Practice roles

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

• Rebound Sports and Orthopedic Physical Therapy, LLC

  • Physical Therapist
  • Anchorage, AK
  • NPI 1407888902
  NPD (past)

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1740782606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7731 E NORTHERN LIGHTS BLVD STE 2",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043572",
            "telephone_number": "907-245-5555",
            "fax_number": "907-333-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7731 E NORTHERN LIGHTS BLVD STE 2",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043572",
            "telephone_number": "907-245-5555",
            "fax_number": "907-333-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "GAYNOR",
        "middle_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AK",
            "license": "129441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Jobe
• Cynthia A Joe, MD
• David Joe, DDS
• Tammy S Joe
• Leah Marie Johannessen, RN
• Sandra Johanson
• John B Dekeyser MD PC
• John D. Erkmann MD, a Professional Corporation
• John D. Erkmann, M.D.
• John D. Frost, M.D., Apc

• Physical Therapy Assistant in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.