STAR JOHNSON (NPI# 1568979235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568979235 |
| Entity Type | Individual |
| Full Name | STAR JOHNSON |
| Practice Address |
201 Thornberry Branch Ln Daytona Beach FL 32124-3652 |
| Practice Telephone | 3868724892 |
| Practice Fax Number | 3862562159 |
| Mailing Telephone | 3868724892 |
| Mailing Fax Number | 3862562159 |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2018-01-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235783366 | Star Marie Johnson | Counselor | 748 14th Ave, Longview, WA 98632-2315 | 2019-07-26 |
| Street Address |
201 THORNBERRY BRANCH LN |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32124-3652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649452376 | Catherine S Brown | Physical Therapist | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2007-12-05 |
| 1780228700 | Emily Bratek | Speech-Language Pathologist | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2019-11-01 |
| 1336781889 | Marilyn Cimafranca | Occupational Therapy Assistant | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2019-10-16 |
| 1578118394 | Ashley Mete | Occupational Therapy Assistant | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2019-08-08 |
| 1457916215 | Matthew Omalley | Specialist/Technologist | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2019-05-07 |
| 1710440276 | Lamesha Doushette Killins | Case Manager/Care Coordinator | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2019-04-11 |
| 1982169454 | Tim Valentine | Occupational Therapy Assistant | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2019-02-08 |
| 1255816427 | Douglas Coney | Occupational Therapy Assistant | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2018-10-03 |
| 1548740475 | Rachel Schatzberg | Early Intervention Provider Agency | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2018-08-20 |
| 1164917688 | Trakenya T Killins | Early Intervention Provider Agency | 201 Thornberry Branch Ln, Daytona Beach, FL 32124-3652 | 2018-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407302599 | Christine Lapila | Behavioral Analyst | 201 Thornberg Branch Lane, Daytona Beach, FL 32124 | 2016-08-29 |
| 1194708495 | Brent N. Fulton | Family Medicine | 3127 W International Speedway Blvd., Daytona Beach, FL 32124 | 2005-11-21 |
| 1588834725 | Glendoria Stephens | Counselor | 3875 Tiger Bay Rd, Rm 914 Bldg I, Daytona Beach, FL 32124 | 2008-03-04 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1376874370 | Sequel Tsi of Florida, LLC Daytona Residential Treatment Center | Psychiatric Residential Treatment Facility | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2010-01-15 |
| 1710531454 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2019-07-31 |
| 1336746544 | Kyle Adams | Pharmacist | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2020-10-01 |
| 1750369666 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Road, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1396742490 | Theodore Frank Matejka | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2005-07-05 |
| 1104464882 | Dane Huge | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2019-12-13 |
| Find all providers in zip 32124 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063929628 | The Rayne Group Inc | Developmental Therapist | 317 Parkway St, Daytona Beach, FL 32114-3031 | 2018-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830595 | Community Children's Therapy, Inc | Developmental Therapist | 12353 Natalies Cove Rd, Cooper City, FL 33330 | 2020-10-27 |
| 1437756327 | Tabrisha Ruy | Developmental Therapist | 10204 Douglas Oaks Cir Apt 304, Tampa, FL 33610-8646 | 2020-10-05 |
| 1316554116 | Carley Alexandra Scartz-nisbet | Developmental Therapist | 9437 Trumpet Vine Loop, Trinity, FL 34655-5366 | 2020-09-25 |
| 1992319909 | Kelly Todd | Developmental Therapist | 1408 Ariel Ln, Fort Walton Beach, FL 32547-1191 | 2020-09-07 |
| 1104436963 | Cassandra Hert | Developmental Therapist | 13738 Alesbury Ct, Jacksonville, FL 32224-2236 | 2020-08-06 |
| 1750991188 | Kimberley Nunez | Developmental Therapist | 362 Nw Stratford Ln, Port Saint Lucie, FL 34983-3432 | 2020-07-31 |
| 1821607441 | Nakeshia Woody | Developmental Therapist | 3209 E North Bay St, Tampa, FL 33610-6927 | 2020-07-29 |
| 1851900922 | Nathalia Brown | Developmental Therapist | 7911 Blairwood Cir S, Lake Worth, FL 33467-1809 | 2020-07-24 |
| 1053929752 | Jill Schnortz | Developmental Therapist | 484 Nw 232nd Ter, Newberry, FL 32669-2282 | 2020-07-20 |
| 1447868310 | Carleen Korkin | Developmental Therapist | 5004 Elpine Way, Palm Beach Gardens, FL 33418-7846 | 2020-07-16 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32124 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.