Tracy Lynne Johnson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

CP014960A Issued in WV

Practice address

887 Lincoln Dr
Conneaut, OH 44030-2135

Phone

(214) 418-4143

NPI assigned

May 16, 2007

Last updated

Sep 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1891902433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 LINCOLN DR",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440302135",
            "telephone_number": "316-708-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 LINCOLN DR",
            "city": "CONNEAUT",
            "state": "OH",
            "postal_code": "440302135",
            "telephone_number": "214-418-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TRACY",
        "middle_name": "LYNNE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2033587",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA005624",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "CP014960A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Robert Huston, DO
• Alissa Ianetta, PSYS
• Kristy Kay Jerina
• John R Meranda & Linda Elaine Weber
• Kathryn Elizabeth Johnson, DPT
• Joseph a Denunzio DDS PC
• Joseph a Denunzio DDS PC
• Manjot K Kang, MD
• Karen Baluch, LPCC Baker Family Counseling
• Mardona Kay Kauffman Treen, LPN

• Physical Therapy Assistant in Conneaut, OH
• Providers in Conneaut, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.