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

Jessica Johnson

Individual provider Physical Therapist · NPI 1205380722

Jessica Johnson is a Physical Therapist in Private Practice in Bridgeton, Missouri. Qualified in 2016, 10 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
10
Licensed in
MO
In the registry since
2016
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Practice location Address checks out

12468 Saint Charles Rock Rd
Bridgeton, MO 63044-2506
Phone: (314) 739-1123
Fax: (314) 739-1173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2016026835 (MO)

Record details

NPI number1205380722
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 12, 2016
Last updated in NPPESJanuary 2, 2025
Certification dateJanuary 2, 2025
Mailing address600 Oakmont Ln, Ste 600c, Westmont, IL 60559-5548

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bridgeton