Healthcare Provider Details

I. General information

NPI: 1417843301
Provider Name (Legal Business Name): KATHERINE JOHNSON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NE 54TH ST STE 101
KANSAS CITY MO
64118-4338
US

IV. Provider business mailing address

200 NE 54TH ST STE 101
KANSAS CITY MO
64118-4338
US

V. Phone/Fax

Practice location:
  • Phone: 816-455-0301
  • Fax: 816-455-0303
Mailing address:
  • Phone: 816-455-0301
  • Fax: 816-455-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2025022956
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: