Tyler L. Johnson, DPT
NPI 1285443820ActiveIndividual· Physical Therapist· Idaho Falls, ID
Physical Therapist (DPT) with Physio Shop Flagstaff LLC, practicing in Idaho Falls, Idaho. Enrolled in Medicare as practitioner - physical medicine and rehabilitation and practitioner - physical therapist in private practice.
Overview
| NPI | 1285443820 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | Yes |
| NPI issued | Jan 7, 2025 |
| Last updated in NPPES | Apr 24, 2026 |
| Certified by provider | Apr 24, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 7571087 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Medicine and Rehabilitation (AZ); Practitioner - Physical Therapist in Private Practice (ID) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physical Medicine And Rehabilitation |
Medical group
- Physio Shop Flagstaff LLCFlagstaff, AZ · 6 clinicians
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