Individual provider Active NPI

Michelle Annikia Johnson, OTR/L

  • Occupational Therapist
  • Fort Myers, FL
National Provider Identifier
1922742584
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT23025 Issued in FL
Practice address
3250 Winkler Ave
Fort Myers, FL 33916-9414
Phone
(239) 939-4993
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT23025 FL Primary

Addresses

Primary practice location

3250 Winkler Ave
Fort Myers, FL 33916-9414

Mailing address

3364 Antica St
Fort Myers, FL 33905-1500
Phone (239) 384-2069

Other practice location 1

2629 Del Prado Blvd S
Cape Coral, FL 33904-5769
Phone (239) 574-4434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718002258 FL Practitioner - Occupational Therapist in Private Practice 8729448089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimized Therapy Transitions LLCGroup PAC ID 6305274812, 10 clinicians

Practice addresses (Care Compare)

7820 Fanning CT
Fort Myers, FL 33907-8508
Phone (239) 237-0501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Sep 30, 2025 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Sep 30, 2025 Accepting new patients
Optimized Therapy Transitions, LLC Occupational Therapist CurrentSince Apr 5, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1922742584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3364 ANTICA ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339051500",
            "telephone_number": "239-384-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WINKLER AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169414",
            "telephone_number": "239-939-4993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2629 Del Prado Blvd S",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339045769",
            "country_code": "US",
            "telephone_number": "239-574-4434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "middle_name": "ANNIKIA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT23025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.