Active NPI
Mia Nichole Johnson
- Physical Therapist
- Lafayette, LA
National Provider Identifier
1972465268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02689
- Practice address
- 300 Rue Beauregard
Lafayette, LA 70508-8511 - Phone
- (337) 261-9188
- NPI assigned
- Nov 25, 2025
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 02689 | LA | Primary |
Addresses
Primary practice location
300 Rue Beauregard
Lafayette, LA 70508-8511
Mailing address
1414 Rupert LK Rd
Eunice, LA 70535
Phone (337) 849-4355
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 |
|---|---|---|---|
| 02689 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764028800000",
"number": "1972465268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 RUPERT LK RD",
"city": "EUNICE",
"state": "LA",
"postal_code": "70535",
"telephone_number": "337-849-4355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 RUE BEAUREGARD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705088511",
"telephone_number": "337-261-9188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MIA",
"middle_name": "NICHOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-25",
"last_updated": "2025-11-25",
"certification_date": "2025-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "02689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.