Garrett Lee Johnson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

294389 Issued in CA

Practice address

2755 Bristol St Ste 130
Costa Mesa, CA 92626-5985

Phone

(714) 966-2950

Fax

(714) 557-2487

NPI assigned

Mar 21, 2018

Sex

Male

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

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Everett Physical Therapy and Sport Performance Center PLLCGroup PAC ID 3779475181, 23 clinicians

Practice addresses (Care Compare)

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.

• Everett Physical Therapy and Sport Performance Center PLLC

  • Physical Therapist
  • Everett, WA
  • NPI 1699713370
  Medicare reassignment Care Compare group NPD
• Everett Physical Therapy and Sport Performance Center PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bothell, WA
  • NPI 1447047477
  NPD
• Everett Physical Therapy and Sport Performance Center PLLC

  • Physical Therapist
  • Kirkland, WA
  • NPI 1003272675
  NPD (past)

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1982108288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 FAMILY TREE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926181089",
            "telephone_number": "206-913-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 BRISTOL ST STE 130",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265985",
            "telephone_number": "714-966-2950",
            "fax_number": "714-557-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARRETT",
        "middle_name": "LEE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew W Johnson, MMS, PA-C
• Antajah T Johnson
• Chianna Emily Johnson
• Clint Johnson
• Elyse Nicole Johnson
• Isabel Johnson
• Jacob Luke Johnson
• Jami Johnson, LCSW
• Jazmyn Brianna Johnson
• Jennifer Michelle Johnson, M.P.H., R.D.

• Physical Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.