Reginald Johnson
Individual provider Active NPI Physical Therapist · Chiefland, FL
NPI 1780133140 · NPPES record last updated Oct 5, 2016
Key facts
- NPI
- 1780133140
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTT 31971 (FL)
- Practice address
- 1315 NW 21St Ave
Suite 3
Chiefland, FL 32626-1977 - Phone
- (352) 493-2999
- NPI assigned
- Sep 27, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTT 31971 | FL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTT 31971 | FL | Yes |
Addresses
Primary practice location
1315 NW 21St Ave
Suite 3
Chiefland, FL 32626-1977
Mailing address
1315 NW 21St Ave
Ste 3
Chiefland, FL 32626-1978
Phone (386) 362-9419
Other providers in Chiefland, FL
- Irene M Boyd Dba/Tri-County Orthotic Prosthetic Institute
- Carla L Jakes
- Jeannette Figueroa
- John Cottam MD PA
- Jennifer Ann Johnson
- Amanda Lynn Kirkland
- Kola Diagnostics LLC
- Jennifer Frances Kyle
- Carolyn Courtney Lee
- Briana K Leverette
All providers in Chiefland, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.