Individual provider Active NPI

Gary Eugene Johnson, DPT

  • Physical Therapist
  • Durham, NC
National Provider Identifier
1760923619
Registry record updated Mar 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15768 Issued in NC
Practice address
3475 Erwin Rd
Durham, NC 27705-0005
Phone
(919) 681-1656
Fax
(919) 668-1451
NPI assigned
Mar 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2017

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 PT15768 NC Primary

Addresses

Primary practice location

3475 Erwin Rd
Durham, NC 27705-0005

Mailing address

Dumc 3965
Durham, NC 27710-0005

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT15768NCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1489276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489276800000",
    "number": "1760923619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DUMC 3965",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277050005",
            "telephone_number": "919-681-1656",
            "fax_number": "919-668-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "EUGENE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-12",
        "last_updated": "2017-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "PT15768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2017; 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.