Individual provider Active NPI

Jasmine Jamila Johnson, DPT

  • Physical Therapist
  • Pontiac, MI
National Provider Identifier
1992339428
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501011549 Issued in MI
Practice address
3000 Centerpoint Pkwy
Pontiac, MI 48341-3116
Phone
(248) 857-6776
Fax
(248) 857-7102
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501011549 MI Primary

Addresses

Primary practice location

3000 Centerpoint Pkwy
Pontiac, MI 48341-3116

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200418000091 MI Practitioner - Physical Therapist in Private Practice 6406286293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Wayne State University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Rehabilitation Specialists of Fowlerville LLCGroup PAC ID 6204730393, 125 clinicians

Practice addresses (Care Compare)

8381 E 12 Mile Rd
Ati Physical Therapy
Warren, MI 48093-2769
Phone (586) 698-1999

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
89.5
Improvement activities
40
Cost
71.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501011549MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mansach Enterprises LLC CurrentSince Feb 9, 2020 Accepting new patients
Mansach Enterprises LLC Physical Therapist CurrentSince Feb 9, 2020 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Dec 13, 2021 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Physical Therapist CurrentSince Dec 13, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

42615 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 412-2845

40097 S Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 468-7612

10078 Lapeer Rd
Ste B
Davison, MI 48423
Phone (810) 653-6200

3000 Centerpoint Pkwy
Pontiac, MI 48341
Phone (248) 857-6776

31120 Gratiot Ave
Roseville, MI 48066
Phone (586) 541-2220

8381 E 12 Mile Rd
Warren, MI 48093
Phone (586) 698-1999

5210 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 674-9560

Organizations & group practices 4

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1992339428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CENTERPOINT PKWY",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483413116",
            "telephone_number": "248-857-6776",
            "fax_number": "248-857-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JASMINE",
        "middle_name": "JAMILA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.