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

Johanna Caroline Provencher, DPT

Individual provider Physical Therapist · NPI 1508481938

Johanna Caroline Provencher, DPT is a Physical Therapist in Private Practice in Gulf Breeze, Florida. Graduated from Mercy College in 2020, 6 years ago. Practices with North Florida Surgeons PA, a 336-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in Florida and North Carolina.

Years since qualifying
6
Trained at
Mercy College
Licensed in
FL, NC
In the registry since
2020
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1040 Gulf Breeze Pkwy Ste 200
Gulf Breeze, FL 32561-7808
Phone: (850) 916-3700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 1040 Gulf Breeze Pkwy Ste 209, Gulf Breeze, FL 32561-7808 — (850) 916-3700
  • 1040 Gulf Breeze Pkwy Ste 207, Gulf Breeze, FL 32561-7808 — (850) 916-3700
  • 5660 Gulf Breeze Pkwy Ste A-1, Gulf Breeze, FL 32563-9599 — (850) 916-3700
  • 4012 N 9th Ave # Pod3, Pensacola, FL 32503-2824 — (850) 807-4200
  • 4406 N Davis Hwy, Pensacola, FL 32503-2756 — (850) 435-4800

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT40856 (FL)
Physical Therapist Taxonomy 225100000X · Licence P19565 (NC)

Record details

NPI number1508481938
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedJune 11, 2020
Last updated in NPPESJanuary 11, 2024
Certification dateJanuary 11, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolMERCY COLLEGE
Graduated 2020 (6 years in practice)
Group practice North Florida Surgeons Pa — 336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Gulf Breeze