Individual provider Active NPI

Johan H Vermaas, BA

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1891821104
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 16648 Issued in CA
Practice address
5213 Mount Alifan Dr
San Diego, CA 92111-2620
Phone
(619) 467-9467
NPI assigned
Feb 23, 2007
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 16648 CA Primary

Addresses

Primary practice location

5213 Mount Alifan Dr
San Diego, CA 92111-2620

Mailing address

5213 Mount Alifan Dr
San Diego, CA 92111-2620
Phone (619) 467-9467

Other practice location 1

5745 ferber street
san diego, CA 92122
Phone (619) 313-7964

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
PT 16648CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brit in Home Physical Therapy LTD Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1891821104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 MOUNT ALIFAN DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112620",
            "telephone_number": "619-467-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5213 MOUNT ALIFAN DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112620",
            "telephone_number": "619-467-9467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5745 ferber street",
            "address_purpose": "LOCATION",
            "city": "san diego",
            "state": "CA",
            "postal_code": "92122",
            "country_code": "US",
            "telephone_number": "619-313-7964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERMAAS",
        "first_name": "JOHAN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 16648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.