Active NPI
Benjamin Johnson III
- Physical Therapy Assistant
- Stratford, CT
National Provider Identifier
1972051613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 001745
- Practice address
- 202 Canaan Rd
Stratford, CT 06614-4611 - Phone
- (203) 260-1581
- NPI assigned
- Sep 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 001745 | CT | Primary |
Addresses
Primary practice location
202 Canaan Rd
Stratford, CT 06614-4611
Mailing address
202 Canaan Rd
Stratford, CT 06614-4611
Phone (203) 260-1581
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 |
|---|---|---|---|
| 001745 | CT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473638400000",
"number": "1972051613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CANAAN RD",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066144611",
"telephone_number": "203-260-1581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 CANAAN RD",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066144611",
"telephone_number": "203-260-1581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BENJAMIN",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-12",
"last_updated": "2016-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "001745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.