MEDICARE: JOHNSTON OCCUPATIONAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist
2	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1396697488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSTON OCCUPATIONAL THERAPY LLC

Provider Business Mailing Address
First Line	:	671 BEAUMONT BEACH RD
Second Line	:
City	:	DOVER
State	:	AR
Zip	:	72837-8639
Country	:	US
Telephone Number	:	479-858-2943
Fax Number	:

Provider Business Practice Location Address
First Line	:	671 BEAUMONT BEACH RD
Second Line	:
City	:	DOVER
State	:	AR
Zip	:	72837-8639
Country	:	US
Telephone Number	:	479-858-2943
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	CHRISTINE JOHNSTON
Credential	:	COTA/L
Telephone Number	:	479-858-2943

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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