Healthcare Provider Details

I. General information

NPI: 1053913616
Provider Name (Legal Business Name): RACHEL LYNN JOHNSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 W 123RD ST
LEAWOOD KS
66209-3172
US

IV. Provider business mailing address

205 E 73RD ST
KANSAS CITY MO
64114-1417
US

V. Phone/Fax

Practice location:
  • Phone: 913-317-2600
  • Fax:
Mailing address:
  • Phone: 618-334-3351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2022034169
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-04612
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.015062
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31007865A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: