Individual provider Active NPI

Lucas Johnson

  • Massage Therapist
  • American Fork, UT
National Provider Identifier
1063255271
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
13872638-4701 Issued in UT
Practice address
366 S 500 E Ste B
American Fork, UT 84003-2526
Phone
(801) 855-5834
NPI assigned
Jun 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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 13872638-4701 UT Primary

Addresses

Primary practice location

366 S 500 E Ste B
American Fork, UT 84003-2526

Mailing address

366 S 500 E Ste B
American Fork, UT 84003-2526
Phone (801) 855-5834

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

State licenses

LicenseStateTypeSpecialty
13872638-4701UTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul and Tasha Massage LLC Massage Therapist CurrentSince Jun 16, 2024 Accepting new patients

Locations

366 S 500 E
#B
American Fork, UT 84003
Phone (801) 855-5834

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1063255271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 S 500 E STE B",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032526",
            "telephone_number": "801-855-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 S 500 E STE B",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032526",
            "telephone_number": "801-855-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LUCAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "UT",
            "license": "13872638-4701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; 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.