Active NPI
Emily Johnson, OT
- Occupational Therapist
- Sandpoint, ID
National Provider Identifier
1851613640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-956
- Practice address
- 1218 N Division Ave
Suite 102
Sandpoint, ID 83864-5054 - Phone
- (208) 304-0652
- NPI assigned
- Feb 19, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-956 | ID | Primary |
Addresses
Primary practice location
1218 N Division Ave
Suite 102
Sandpoint, ID 83864-5054
Mailing address
1218 N Division Ave
Suite 102
Sandpoint, ID 83864-5054
Phone (208) 304-0652
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT956 | Other | ID | STATE OF IDAHO OCCUPATIONAL THERAPY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT-956 | ID | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids in Motion Physical Therapy, PC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1266537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266537600000",
"number": "1851613640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 N DIVISION AVE",
"address_2": "SUITE 102",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838645054",
"telephone_number": "208-304-0652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1218 N DIVISION AVE",
"address_2": "SUITE 102",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838645054",
"telephone_number": "208-304-0652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "EMILY",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-19",
"last_updated": "2010-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-956",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF IDAHO OCCUPATIONAL THERAPY LICENSE",
"identifier": "OT956",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.