Individual provider Active NPI

Johannes Henricus Van Ooyen, PT, MTC

  • Physical Therapist
  • Fort Defiance, AZ
National Provider Identifier
1902220262
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28982 Issued in FL
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504
Phone
(928) 729-8000
NPI assigned
Feb 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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 PT28982 FL Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140702000960 FL Practitioner - Physical Therapist in Private Practice 7416172648 Reassigns benefits to 1 organization
I20230728001597 TX Practitioner - Physical Therapist in Private Practice 7416172648 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28982FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ewing and Thomas, Inc. Physical Therapist CurrentSince Feb 1, 2014 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Jul 10, 2023 Accepting new patients
Ewing and Thomas, Inc Physical Therapist CurrentSince Feb 1, 2014 Accepting new patients

Locations

11329 Cortez Blvd
Brooksville, FL 34613
Phone (352) 340-5935

5311 Grand Blvd
New Prt Rchy, FL 34652
Phone (727) 848-3962

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1902220262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN OOYEN",
        "first_name": "JOHANNES",
        "middle_name": "HENRICUS",
        "credential": "PT, MTC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.