Individual provider Active NPI

Sabrena Johnson

  • Physical Therapy Assistant
  • Orlando, FL
National Provider Identifier
1770976151
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306001209 Issued in VA
Practice address
12124 High Tech Ave
Ste. 300
Orlando, FL 32817-8373
Phone
(800) 774-7785
Fax
(877) 217-9271
NPI assigned
Mar 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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 2306001209 VA Primary

Addresses

Primary practice location

12124 High Tech Ave
Ste. 300
Orlando, FL 32817-8373

Mailing address

12124 High Tech Ave
Ste. 300
Orlando, FL 32817-8373
Phone (800) 774-7785

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
2306001209VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1770976151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12124 HIGH TECH AVE",
            "address_2": "STE. 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328178373",
            "telephone_number": "800-774-7785",
            "fax_number": "877-217-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12124 HIGH TECH AVE",
            "address_2": "STE. 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328178373",
            "telephone_number": "800-774-7785",
            "fax_number": "877-217-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SABRENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306001209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.