Individual provider Active NPI

Derek T Johnson, PT

  • Physical Therapist
  • Savannah, GA
National Provider Identifier
1922059872
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008091 Issued in GA
Practice address
4425 Paulsen St
Savannah, GA 31405-3637
Phone
(912) 354-5100
Fax
(912) 354-5970
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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 PT008091 GA Primary

Addresses

Primary practice location

4425 Paulsen St
Savannah, GA 31405-3637

Mailing address

4425 Paulsen St
Savannah, GA 31405-3637
Phone (912) 354-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060222000400 GA Practitioner - Physical Therapist in Private Practice 4587670989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chatham Orthopaedic Associates PAGroup PAC ID 8022910306, 55 clinicians

Practice addresses (Care Compare)

4425 Paulsen St
A
Savannah, GA 31405-3637
Phone (912) 354-5100

Merit-based Incentive Payment System (MIPS)

Final score
84 of 100Reported as group
Quality
65.06
Promoting interoperability
98
Improvement activities
40
Cost
83.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT008091GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chatham Orthopaedic Associates, PA CurrentSince Jan 1, 2006 Accepting new patients
Chatham Orthopaedic Associates, PA Physical Therapist CurrentSince Jan 1, 2006 Accepting new patients
Effingham Orthopedic Practice, LLC CurrentSince Jan 1, 2017 Accepting new patients

Locations

20 William Blakely Xing
Pooler, GA 31322

1203 Gandy Dancer
Richmond Hill, GA 31324
Phone (912) 355-6651

613 Towne Park Dr W
Rincon, GA 31326
Phone (912) 208-4776

613 Towne Park Dr W
Ste 303304
Rincon, GA 31326
Phone (912) 826-3111

613 Towne Park Dr W
Ste 303
Rincon, GA 31326
Phone (912) 826-3111

4425 Paulsen St
Bldg A
Savannah, GA 31405
Phone (912) 350-6000

4425 Paulsen St
Fl 2A
Savannah, GA 31405

4425 Paulsen St
Bldg B
Savannah, GA 31405

4425 Paulsen St
Fl 2
Savannah, GA 31405
Phone (912) 350-2820

4425 Paulsen St
Savannah, GA 31405
Phone (912) 354-5100

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

Interoperability endpoints

  • Direct secure messaging: derek.johnson.2@18355.direct.athenahealth.com

Organizations & group practices 4

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1922059872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 PAULSEN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314053637",
            "telephone_number": "912-354-5100",
            "fax_number": "912-354-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 PAULSEN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314053637",
            "telephone_number": "912-354-5100",
            "fax_number": "912-354-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEREK",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.