Johnnie Harrison, DPT
Individual provider Active NPI Physical Therapist · Quartz Hill, CA
NPI 1881097491 · NPPES record last updated May 2, 2023
Key facts
- NPI
- 1881097491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 36717 (CA)
- Practice address
- 42055 50TH St W Ste 10
Quartz Hill, CA 93536-3520 - Phone
- (661) 418-6880
- Fax
- (661) 466-5027
- NPI assigned
- Sep 28, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
42055 50TH St W
Suite 10
Quartz Hill, CA 93536-3520
Phone (661) 418-6880
8591 W Pico Blvd
Los Angeles, CA 90035-2412
Phone (323) 934-2582
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150908001338 | CA | Practitioner - Physical Therapist in Private Practice | 9133435167 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36717 | CA | MD | Licensed Psychiatric Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pico Athletic Club Inc | Physical Therapist | Current |
Accepting new patients |
Locations
8591 W Pico Blvd
Los Angeles, CA 90035
Phone (323) 934-2582
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 36717 | CA | Yes |
Addresses
Primary practice location
42055 50TH St W Ste 10
Quartz Hill, CA 93536-3520
Mailing address
2517 Paintbrush Dr
Palmdale, CA 93551-6209
Phone (661) 350-0590
Other practice location 1
43051 15th St W
Lancaster, CA 93534-6906
Phone (661) 899-5668
Other providers in Quartz Hill, CA
- George Louis Collucci
- Ronald Spiro Columbo
- Marjorie B. Del Aguila
- Donald N Iwuagwu
- Emily Fernandez
- Michelle C Harrison
- Glen Allen Horst
- Patricia Hull
- Independence Community Treatment Clinic
- Donald Iwuagwu
All providers in Quartz Hill, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.