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

Individual provider Occupational Therapist · NPI 1033094792

Mattea Johnson, OTR/L is an Occupational Therapist in Private Practice in Fargo, North Dakota. Qualified in 2025, 1 year ago. Licensed in North Dakota.

Years since qualifying
1
Licensed in
ND
In the registry since
2025
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

3120 25th St S Ste N
Fargo, ND 58103-6110
Phone: (701) 205-4194
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 2225 (ND)

Record details

NPI number1033094792
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedAugust 11, 2025
Last updated in NPPESAugust 11, 2025
Certification dateAugust 11, 2025
Mailing address3120 25th St S Ste N, Fargo, ND 58103-6110

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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