Nikki Johnson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05012253A Issued in OH

Practice address

7930 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Phone

(260) 432-5800

NPI assigned

Oct 14, 2016

Last updated

Sep 20, 2017By 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 1

Addresses

Other identifiers 1

Other names 1

• Nikki McCoy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Indiana Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Bluffton, IN
  • NPI 1629110192

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1912458910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-432-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NIKKI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "05012253A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201397670",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "MCCOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lon P Johnson, MA
• Mary B Johnson, PH.D
• Mary M Johnson, MSN, RN
• Michelle Johnson
• Morgan Johnson, RBT
• Philip James Johnson, MD
• Rachael L Johnson, NP
• Renu Johnson
• Rochelle Loraine Johnson, N.P.
• Sara B Johnson, SLP

• Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.