Active NPI
Reginald Johnson
- Physical Therapist
- Chiefland, FL
National Provider Identifier
1780133140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTT 31971
- Practice address
- 1315 NW 21St Ave
Suite 3
Chiefland, FL 32626-1977 - Phone
- (352) 493-2999
- NPI assigned
- Sep 27, 2016
- Last updated
- Oct 5, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTT 31971 | FL | Primary |
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTT 31971 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475625600000",
"number": "1780133140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 NW 21ST AVE",
"address_2": "STE 3",
"city": "CHIEFLAND",
"state": "FL",
"postal_code": "326261978",
"telephone_number": "386-362-9419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 NW 21ST AVE",
"address_2": "SUITE 3",
"city": "CHIEFLAND",
"state": "FL",
"postal_code": "326261977",
"telephone_number": "352-493-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "REGINALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-27",
"last_updated": "2016-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PTT 31971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chiefland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.