Individual provider Active NPI

John G. Moore, ASSOCIATE DEGREE

  • Massage Therapist
  • Brooklyn, NY
National Provider Identifier
1043940216
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
032843 Issued in NY
Practice address
300 Bainbridge St
Brooklyn, NY 11233-1957
Phone
(347) 641-7365
NPI assigned
Jun 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 032843 NY Primary

Addresses

Primary practice location

300 Bainbridge St
Brooklyn, NY 11233-1957

Mailing address

300 Bainbridge St
Brooklyn, NY 11233-1957

Other practice location 1

464 Manor Rd
Staten Island, NY 10314-2956
Phone (718) 442-6690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1043940216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BAINBRIDGE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112331957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BAINBRIDGE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112331957",
            "telephone_number": "347-641-7365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "464 Manor Rd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103142956",
            "country_code": "US",
            "telephone_number": "718-442-6690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "G.",
        "credential": "ASSOCIATE DEGREE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "032843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.