Individual provider Active NPI

Bettye Jo Johnson, PTA

  • Physical Medicine & Rehabilitation Physician
  • Raleigh, NC
National Provider Identifier
1821396185
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
244 Issued in NC
Practice address
11200 Governor Manly Way, Suite 305
Orhopaedic Specialists of North Carolina, PA
Raleigh, NC 27614
Phone
(919) 562-9410
Fax
(919) 562-9425
NPI assigned
Mar 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 244 NC Primary

Addresses

Primary practice location

11200 Governor Manly Way, Suite 305
Orhopaedic Specialists of North Carolina, PA
Raleigh, NC 27614

Mailing address

311 Riggsbee Farm Dr
Cary, NC 27519-7354
Phone (919) 319-0952

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
244NCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1821396185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 RIGGSBEE FARM DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275197354",
            "telephone_number": "919-319-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY, SUITE 305",
            "address_2": "ORHOPAEDIC SPECIALISTS OF NORTH CAROLINA, PA",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27614",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BETTYE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.