Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fred Kendall Johnson, DPT

Individual provider Physical Therapist · NPI 1689826554

Fred Kendall Johnson, DPT is a Physical Therapist in Private Practice in Tyndall AFB, Florida. Qualified in 2007, 19 years ago. Practices with Premier Physical Therapy Sport Medicine Inc, a 37-clinician group and accepts Medicare assignment. Licensed in Florida and New York.

Years since qualifying
19
Licensed in
FL, NY
In the registry since
2008
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

325 Mdg 340 Magnolia Cir
Tyndall AFB, FL 32403
Phone: (850) 283-7019
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT25177 (FL)
Physical Therapist Taxonomy 225100000X · Licence 029708 (NY)

Record details

NPI number1689826554
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedOctober 22, 2008
Last updated in NPPESJuly 22, 2021
Certification dateJuly 22, 2021
Mailing address359 Se 7th St, Dania Beach, FL 33004-4403

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Premier Physical Therapy Sport Medicine Inc — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Tyndall AFB