Individual provider Active NPI

Amy Marie Johnson, MPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1780768465
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29367 Issued in CA
Practice address
2740 Butler Ave
Los Angeles, CA 90064-3806
Phone
(310) 351-1464
Fax
(424) 256-2300
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT29367 CA
Physical Therapist 225100000X 29367 CA Primary

Addresses

Primary practice location

2740 Butler Ave
Los Angeles, CA 90064-3806

Mailing address

3008 Military Ave
Los Angeles, CA 90034-3015

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
PT29367CAMDPhysical Therapist
29367CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Performance Physical Therapy, Inc. Physical Therapist CurrentSince Feb 6, 2022 Accepting new patients
Independent Physical Therapy Inc Physical Therapist Past Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist PastSince Jun 1, 2013 Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1780768465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 MILITARY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 BUTLER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643806",
            "telephone_number": "310-351-1464",
            "fax_number": "424-256-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29367",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.