Glen Eric Johnson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT001236A Issued in PA

Practice address

3280 Fissels Church Rd
Glen Rock, PA 17327-8774

Phone

(717) 235-4811

NPI assigned

Apr 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern York County School District

  • Local Education Agency (LEA)
  • Glen Rock, PA
  • NPI 1922121516
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750505566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CAPRI CIR",
            "city": "LEWISBERRY",
            "state": "PA",
            "postal_code": "173399584",
            "telephone_number": "717-932-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 FISSELS CHURCH RD",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173278774",
            "telephone_number": "717-235-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLEN",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT001236A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Rock Emergency Medical Services Inc
• Glen Rock Home Care LLC
• Kallie Lynn Heiges, LAT, ATC
• A. Douglas Hunger III, DDS
• Robert Louis Jackson Jr., D.C.
• Jonelle Lynn Lund, RN BSN IBCLC
• Maggie Smith Pmhnp PLLC
• Giullia Matteo, TRADITIONAL MIDWIFE
• Mindful Connections Professional Counseling Services LLC
• Mindful Wellness Counseling, LLC.

• Athletic Trainer in Glen Rock, PA
• Providers in Glen Rock, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.