Active NPI
Diane Karen Johnson, OTR
- Occupational Therapist
- Talent, OR
National Provider Identifier
1952562001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 914267
- Practice address
- 175 Suncrest Rd
Talent, OR 97540-8686 - Phone
- (541) 535-7772
- NPI assigned
- Jun 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 914267 | OR | Primary |
| Occupational Therapist | 225X00000X | OT 00001834 | WA |
Addresses
Primary practice location
175 Suncrest Rd
Talent, OR 97540-8686
Mailing address
175 Suncrest Rd
Talent, OR 97540-8686
Phone (541) 535-7772
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119003 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 914267 | OR | MD | Occupational Therapist |
| OT 00001834 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213920000000",
"number": "1952562001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 SUNCREST RD",
"city": "TALENT",
"state": "OR",
"postal_code": "975408686",
"telephone_number": "541-535-7772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 SUNCREST RD",
"city": "TALENT",
"state": "OR",
"postal_code": "975408686",
"telephone_number": "541-535-7772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DIANE",
"middle_name": "KAREN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-20",
"last_updated": "2008-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "914267",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT 00001834",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119003",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Talent, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.