Kathleen Sarah Johnson, PT

Primary specialty

ContractorTaxonomy code 171W00000X

License

PT9855 Issued in CA

Practice address

587 Palm Canyon Dr Ste. 204
Borrego Springs, CA 92004-2630

Phone

(760) 767-4047

Fax

(760) 767-4048

NPI assigned

Nov 23, 2005

Last updated

Jul 19, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1851374805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2630",
            "city": "BORREGO SPRINGS",
            "state": "CA",
            "postal_code": "920042630",
            "telephone_number": "760-767-4047",
            "fax_number": "760-767-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 PALM CANYON DR STE. 204",
            "city": "BORREGO SPRINGS",
            "state": "CA",
            "postal_code": "920042630",
            "telephone_number": "760-767-4047",
            "fax_number": "760-767-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHLEEN",
        "middle_name": "SARAH",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "CA",
            "license": "PT9855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4006834",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dap Health, Inc. (DAP Health-Borrego Springs Community Health Center)
• Dap Health, Inc. (Borrego Springs Pharmacy)
• Shrinda Gamache, DACM
• Denise Gordon, PSYCHOLOGIST
• James M Huot, M.D.
• Chris Marshall
• Timothy Steven Martinez, DMD
• Pamela Thompson McEvoy, PHD PSYCHOLOGIST
• Mercy Air Service, Inc.
• Ann Morton Nourse, P.T.

• Contractor in Borrego Springs, CA
• Providers in Borrego Springs, CA by specialty
• Contractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.