Sue Johnson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3455 Issued in NC

Practice address

2413 Professional Dr
Rocky Mount, NC 27804-2254

Phone

(252) 443-0808

Fax

(252) 451-9032

NPI assigned

May 19, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Boice-Willis Clinic PA

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1699722389
  NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1972556785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 PROFESSIONAL DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042254",
            "telephone_number": "252-443-0808",
            "fax_number": "252-451-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 PROFESSIONAL DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042254",
            "telephone_number": "252-443-0808",
            "fax_number": "252-451-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "3455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212407",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "195517",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5529094",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46447",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ciera Johnson
• Felicia Johnson, LPN
• H. Mike Johnson, O.D.
• Karen Johnson, CNM
• Kenneth Johnson
• Winnie Johnson, MS-CCCSLP
• Amanda Johnston, PT
• Barbara Dawn Johnston, BS/MS
• Jomko Haus, LLC
• Jones and Jones Enterprises LLC

• Physical Therapist in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.

Verify at the official NPI Registry.