Michael Ryan Johnson (NPI# 1477628535, PAC ID# 6406018613) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1477628535 |
| PAC ID by PECOS | 6406018613 |
| Professional Enrollment ID | I20120504000475 |
| Full Name | Michael Ryan Johnson |
| Organization Legal Name | BOOST SPORTS PERFORMANCE LLC |
| Address |
3801 Selsa Rd Suite 7 Independence MO 64057-1712 |
| Phone Number | 8167950434 |
| Gender | M |
| Graduation Year | 2000 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 8921171604 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 | 8167950434 | BOOST SPORTS PERFORMANCE LLC |
| 1254 Se Century Dr, Lees Summit, MO 64081-3286 | 8165241442 | BOOST SPORTS PERFORMANCE LLC |
| 16052 Foster St, Overland Park, KS 66085-8876 | 9138978960 | BSP KANSAS LLC |
| Organization Legal Name | BOOST SPORTS PERFORMANCE LLC |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hana Petersen | Physical Therapy | Boost Sports Performance LLC | 17011 Bel Ray Blvd Belton Raymore, Belton, MO 64012-5371 |
| Edward Pilgrim | Physical Therapy | Boost Sports Performance LLC | 1254 Se Century Dr, Lees Summit, MO 64081-3286 |
| Samantha Lee Linville | Physical Therapy | Boost Sports Performance LLC | 1460 Nw Olympic Dr, Suite J, Grain Valley, MO 64029-7865 |
| William Patrick Streck | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Patnakon Kevin Sonthana | Physical Therapy | Boost Sports Performance LLC | 2105 Kara Ct, Suite 1 A, Liberty, MO 64068-1395 |
| Zachary T Koelling | Physical Therapy | Boost Sports Performance LLC | 2105 Kara Ct, Suite 1 A, Liberty, MO 64068-1395 |
| Thomas Hargrave | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Aaron D Horschig | Physical Therapy | Boost Sports Performance LLC | 2105 Kara Ct, Suite 1 A, Liberty, MO 64068-1395 |
| Mary Suellentrop | Physical Therapy | Boost Sports Performance LLC | 17011 Bel Ray Blvd Belton Raymore, Belton, MO 64012-5371 |
| Zachary Lee Hershberger | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Street Address |
3801 SELSA RD SUITE 7 |
| City | INDEPENDENCE |
| State | MO |
| Zip | 64057-1712 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William Patrick Streck | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Thomas Hargrave | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Zachary Lee Hershberger | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Diana Anderson | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Dylan Hoz-kurland | Physical Therapy | Boost Sports Performance LLC | 3801 Selsa Rd, Suite 7, Independence, MO 64057-1712 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James W Lindsey | Chiropractic | 2333s 291 Hwy, Independence, MO 64057 | |
| Christopher Wise | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Andre M Jakoi | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Courtney Adams | Physician Assistant | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Jeffrey A Krempec | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Nathan J Kiewiet | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Janese B Surber | Nurse Practitioner | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Nikki A Vogel | Physician Assistant | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Zachary V Roberts | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Alexa Kyl Moberly | Physician Assistant | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Find all physicians in zip 64057 | |||
| City | INDEPENDENCE |
| Zip Code | 64057 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | INDEPENDENCE + PHYSICAL THERAPY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.