Individual provider Active NPI

Justin Conway

  • Massage Therapist
  • Apple Valley, CA
National Provider Identifier
1215812003
Registry record updated Aug 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
95767 Issued in CA
Practice address
16084 Pawnee Rd
Apple Valley, CA 92307-1840
Phone
(916) 220-2727
NPI assigned
Aug 9, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2025

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 95767 CA Primary

Addresses

Primary practice location

16084 Pawnee Rd
Apple Valley, CA 92307-1840

Mailing address

16084 Pawnee Rd
Apple Valley, CA 92307-1840
Phone (916) 220-2727

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
95767CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1754697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1215812003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16084 PAWNEE RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071840",
            "telephone_number": "916-220-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16084 PAWNEE RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071840",
            "telephone_number": "916-220-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-09",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "95767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2025; 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.