Scott Patrick Johnson, A.T.,C
Specialist/Technologist, Athletic Trainer in Modesto, CA. Individual provider (NPI-1).
NPI number1700948833
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1700948833
- Entity type
- Individual (NPI-1)
- Name
- Mr. Scott Patrick Johnson
- Credential
- A.T.,C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 14, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
1611 Scenic DrModesto, CA 95355-4907
Phone 209-576-1805
Mailing address
901 Edison AveModesto, CA 95350-5548
Phone 209-544-0984
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 18 Athletic Trainer providers in Modesto · All 10,803 providers in Modesto
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