Jan J Johnson, PT
Individual provider Active NPI Physical Therapist · Stowe, VT
NPI 1952425662 · NPPES record last updated Oct 21, 2022
Key facts
- NPI
- 1952425662
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 040-0002878 (VT)
- Practice address
- 1878 Mountain Rd Ste 1
Stowe, VT 05672-4775 - Phone
- (802) 253-2273
- Fax
- (802) 253-7754
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Legacy Healthcare Services Inc
Practice addresses (Care Compare)
2395 Minton Rd
West Melbourne, FL 32904-6607
Phone (321) 821-2311
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221031000002 | FL | Practitioner - Physical Therapist in Private Practice | 3870749187 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040-0002878 | VT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Physical Therapist | Current |
Accepting new patients |
| Legacy Healthcare Services, Inc | Physical Therapist | Current |
Accepting new patients |
| Empowerme Rehabilitation Florida, LLC | Current |
Accepting new patients | |
| Empowerme Rehabilitation Florida, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654
8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979
2395 Minton Rd
West Melbourne, FL 32904
Phone (321) 220-0295
38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040-0002878 | VT | Yes |
Addresses
Primary practice location
1878 Mountain Rd Ste 1
Stowe, VT 05672-4775
Mailing address
220 Thomas LN
Stowe, VT 05672-5060
Phone (802) 253-8869
Other names
- Jan Hulse
Other providers in Stowe, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.