Jade Johnson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA29010 Issued in FL

Practice address

3050 Woodmont Ave
Winter Haven, FL 33884-3800

Phone

(727) 803-1102

NPI assigned

Aug 14, 2019

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1962058008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 1ST AVE S STE 200",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014364",
            "telephone_number": "727-803-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 WOODMONT AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843800",
            "telephone_number": "727-803-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JADE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eve Johnson, PA-C
• Faith E Johnson, ARNP-C
• Gary R Johnson, MD
• Heather Dawn Johnson, OTR/L
• Henry D Johnson
• Kennethia Johnson
• Martin Robert Johnson, R.PH.
• Precious Johnson
• Ryan Wesley Johnson, D.O.
• Thomas Richard Johnson, D.D.S.

• Physical Therapy Assistant in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.