Individual provider Active NPI

Justin M Ordon, L.M.T

  • Massage Therapist
  • Lancaster, NY
National Provider Identifier
1124238647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27017513 Issued in NY
Practice address
4917 William St
Suite a
Lancaster, NY 14086-3200
Phone
(716) 706-0005
Fax
(716) 706-0220
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 27017513 NY Primary

Addresses

Primary practice location

4917 William St
Suite a
Lancaster, NY 14086-3200

Mailing address

6484 Broadway St
Lancaster, NY 14086-9555

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
27017513NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124238647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6484 BROADWAY ST",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140869555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 WILLIAM ST",
            "address_2": "SUITE A",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140863200",
            "telephone_number": "716-706-0005",
            "fax_number": "716-706-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDON",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "L.M.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "27017513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.