Individual provider Active NPI

Martha Johnston, PTA

  • Physical Therapy Assistant
  • Grandville, MI
National Provider Identifier
1992299572
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502000187 Issued in MI
Practice address
3400 Wilson Ave SW
Grandville, MI 49418-1854
Phone
(616) 534-5487
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502000187 MI Primary

Addresses

Primary practice location

3400 Wilson Ave SW
Grandville, MI 49418-1854

Mailing address

6331 Rushview Dr
Hudsonville, MI 49426-9085
Phone (810) 820-0408

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

LicenseStateTypeSpecialty
5502000187MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1992299572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 RUSHVIEW DR",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494269085",
            "telephone_number": "810-820-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WILSON AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181854",
            "telephone_number": "616-534-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MARTHA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502000187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.