Douglas Johnson

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4559

Practice address

201 S 7TH St
Heber Springs, AR 72543-3718

Phone

(501) 362-8118

Fax

(501) 362-8119

NPI assigned

May 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Ivy Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Heber Springs, AR
  • NPI 1053695551
  NPD

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1902542004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 7TH ST",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725433718",
            "telephone_number": "501-362-8118",
            "fax_number": "501-362-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 7TH ST",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725433718",
            "telephone_number": "501-362-8118",
            "fax_number": "501-362-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": "PTA4559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivy Physical Therapy, Inc
• Jamie Carol Ivy, PHARMD
• Laura Lynn Ivy
• Jennifer Diane Jenkins, APN
• Sarah Witt Jewell, M.D.
• Joseph B Sugg, O.D., P.a.
• Amy Julian, MD
• Seth Daniel Justice, MD
• Kristie Kelso-Welsh
• Carol Renea Kerby, PHARMD

• Physical Therapy Assistant in Heber Springs, AR
• Providers in Heber Springs, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.