Individual provider Active NPI

Michael Rory Johnston, OTR/L, CLWT

  • Occupational Therapist
  • Estherville, IA
National Provider Identifier
1972080919
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
002407 Issued in IA
Practice address
826 N 8TH St
Estherville, IA 51334-1528
Phone
(712) 362-6118
NPI assigned
Jul 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 104623 MN
Occupational Therapist 225X00000X 002407 IA Primary

Addresses

Primary practice location

826 N 8TH St
Estherville, IA 51334-1528

Mailing address

826 N 8TH St
Estherville, IA 51334-1528
Phone (712) 362-6118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200828001087 IA Practitioner - Occupational Therapist in Private Practice 4880011352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie County HospitalGroup PAC ID 6204745110, 16 clinicians

Practice addresses (Care Compare)

312 N Fremont St B
Stuart Rehab Clinic
Stuart, IA 50250-2083
Phone (515) 523-8049

710 N 12TH St
Guthrie Center, IA 50115-1549
Phone (641) 332-2201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002407IAMDOccupational Therapist
104623MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie County Hospital CurrentSince Aug 13, 2020 Accepting new patients
Guthrie County Hospital CurrentSince Aug 13, 2020 Accepting new patients
Guthrie County Hospital Past Accepting new patients

Locations

710 N 12th St
Guthrie Ctr, IA 50115
Phone (641) 332-2201

312 N Fremont St
Ste B
Stuart, IA 50250
Phone (515) 523-8049

312 N Fremont St
Stuart, IA 50250
Phone (515) 523-2187

Organizations & group practices 5

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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1972080919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 N 8TH ST",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341528",
            "telephone_number": "712-362-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N 8TH ST",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341528",
            "telephone_number": "712-362-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MICHAEL",
        "middle_name": "RORY",
        "name_prefix": "Mr.",
        "credential": "OTR/L, CLWT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104623",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "002407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estherville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.