Johanna E Mastry, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011163 Issued in MI

Practice address

23100 Providence Dr
Suite 135
Southfield, MI 48075-3646

Phone

(248) 905-5180

NPI assigned

Sep 24, 2012

Sex

Female

Sole proprietor

Yes

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

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 and National Provider Directory roles.

• New Center Rehabilitation, Inc

  • Physical Therapist
  • Southfield, MI
  • NPI 1407018351
  NPD (past)
• Quickstar Home Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Oak Park, MI
  • NPI 1982611042
  NPD (past)
• Village Center Physical Therapy LLC

  • Physical Therapist
  • Southfield, MI
  • NPI 1427387497
  NPD (past)

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1942551528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23100 PROVIDENCE DR",
            "address_2": "SUITE 135",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753646",
            "telephone_number": "248-905-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 PROVIDENCE DR",
            "address_2": "SUITE 135",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753646",
            "telephone_number": "248-905-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRY",
        "first_name": "JOHANNA",
        "middle_name": "E",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan William Mast, TLLP
• Madelyn Sue Mastenbrook
• Master Medical, PLLC
• Sergey Masterov, MASSAGE THERAPIST
• Sabrina Lauren Mastronardi, PHARMD
• Lori Ann Matheson, LLPC
• Nancy K Mathew, RPT
• Toms K Mathew, RPT
• Ashlyn Mathewson
• Tina Mathewson

• Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.