Individual provider Active NPI

Kimberly Johnston, PT, DPT

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1942630033
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1237631 Issued in TX
Practice address
2158 Portsmouth St
Houston, TX 77098-4057
Phone
(713) 529-4990
Fax
(713) 523-2452
NPI assigned
Nov 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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 1237631 TX Primary

Addresses

Primary practice location

2158 Portsmouth St
Houston, TX 77098-4057

Mailing address

2158 Portsmouth St
Houston, TX 77098-4057

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118002446 CO Practitioner - Physical Therapist in Private Practice 6002124831 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5009OKMDPharmacy Technician
1237631TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jan 9, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 9, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 9, 2024 Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist Past Accepting new patients
Select Physical Therapy Holdings Inc PastSince Jun 22, 2015 Accepting new patients

Locations

500 Eldorado Blvd
Bldg 4
Broomfield, CO 80021
Phone (303) 812-4790

501 S Cherry St
Fl 11
Denver, CO 80246
Phone (309) 530-8782

8550 W 38th Ave
Ste 100
Wheat Ridge, CO 80033
Phone (303) 467-4100

Organizations & group practices 6

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": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1942630033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 PORTSMOUTH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 PORTSMOUTH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984057",
            "telephone_number": "713-529-4990",
            "fax_number": "713-523-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KIMBERLY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-26",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1237631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.