Blake Johnson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

304474 Issued in CA

Practice address

2204 S El Camino Real Ste 225
Oceanside, CA 92054-6376

Phone

(858) 755-5200

Fax

(760) 826-2525

NPI assigned

Aug 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Rise Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Solana Beach, CA
  • NPI 1083038764

  Physical Therapist

  NPD

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1790560969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 STEVENS AVE STE 314",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752069",
            "telephone_number": "858-755-5200",
            "fax_number": "858-755-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S EL CAMINO REAL STE 225",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546376",
            "telephone_number": "858-755-5200",
            "fax_number": "760-826-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul David Johenk, D.O.
• John M Kroener a Medical Corporation
• Andrew K John, DDS
• Lacy Johnson-Bathurst
• Allison Johnson, MA, MFT
• Chrisanna Johnson, M.D.
• Jovannie Johnson
• Kristopher Phillip Johnson, MD
• Leah Dale Johnson, DC
• Melyssa Johnson, OT

• Physical Therapist in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.