Individual provider Active NPI

Alyssa Johnson, PT, DPT

  • Physical Therapist
  • Newport News, VA
National Provider Identifier
1891241170
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305211792 Issued in VA
Practice address
860 Omni Blvd Ste 103
Newport News, VA 23606-4430
Phone
(757) 223-9403
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0014111 CO
Physical Therapist 225100000X 2305211792 VA Primary

Addresses

Primary practice location

860 Omni Blvd Ste 103
Newport News, VA 23606-4430

Mailing address

860 Omni Blvd Ste 303
Newport News, VA 23606-4477
Phone (757) 232-8769

Other practice location 1

22415 Sunset Dr
Golden, CO 80401-9570
Phone (303) 908-9572

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0014111COMDPhysical Therapist
2305211792VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1891241170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064477",
            "telephone_number": "757-232-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 103",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-223-9403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22415 Sunset Dr",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804019570",
            "country_code": "US",
            "telephone_number": "303-908-9572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALYSSA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0014111",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.