Individual provider Active NPI

Brynn Johnson

  • Physical Therapy Assistant
  • Des Moines, IA
National Provider Identifier
1871037416
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
083647 Issued in IA
Practice address
2100 Dixon St
Suite C
Des Moines, IA 50316-2174
Phone
(515) 265-1020
NPI assigned
Dec 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 083647 IA Primary

Addresses

Primary practice location

2100 Dixon St
Suite C
Des Moines, IA 50316-2174

Mailing address

880 NE Horizon Dr
11-120
Waukee, IA 50263-8050
Phone (815) 674-7651

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
083647IAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1871037416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 NE HORIZON DR",
            "address_2": "11-120",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502638050",
            "telephone_number": "815-674-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DIXON ST",
            "address_2": "SUITE C",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162174",
            "telephone_number": "515-265-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-16",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "083647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.