Individual provider Active NPI

Johnson Emmanuel

  • Physical Therapy Assistant
  • Pembroke Pines, FL
National Provider Identifier
1912899105
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA32421 Issued in FL
Practice address
8150 Pines Blvd
Pembroke Pines, FL 33024-6710
Phone
(754) 208-3765
NPI assigned
Jul 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X PTA32421 FL Primary

Addresses

Primary practice location

8150 Pines Blvd
Pembroke Pines, FL 33024-6710

Mailing address

2843 SW 179TH Ter
Miramar, FL 33029-5165
Phone (954) 213-5209

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA32421FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jade Therapeutics Inc Single Specialty CurrentSince Jul 28, 2025 Accepting new patients
Physical Therapy Now Holdings, LLC PastSince Jul 28, 2025 Accepting new patients

Locations

8150 Pines Blvd
Pembroke Pines, FL 33024
Phone (754) 208-3765

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1912899105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2843 SW 179TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295165",
            "telephone_number": "954-213-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246710",
            "telephone_number": "754-208-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMANUEL",
        "first_name": "JOHNSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA32421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; 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.