Active NPI
Avvonlea Johnnie Gonzales
- Massage Therapist
- Philadelphia, PA
National Provider Identifier
1316696719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MSG014562
- Practice address
- 305 S Iseminger St Apt 6
Philadelphia, PA 19107-5952 - Phone
- (806) 535-3723
- NPI assigned
- Mar 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MSG014562 | PA | Primary |
Addresses
Primary practice location
305 S Iseminger St Apt 6
Philadelphia, PA 19107-5952
Mailing address
305 S Iseminger St Apt 6
Philadelphia, PA 19107-5952
Phone (806) 535-3723
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
| License | State | Type | Specialty |
|---|---|---|---|
| MSG014562 | PA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647907200000",
"number": "1316696719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 S ISEMINGER ST APT 6",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075952",
"telephone_number": "806-535-3723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 S ISEMINGER ST APT 6",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191075952",
"telephone_number": "806-535-3723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "AVVONLEA",
"middle_name": "JOHNNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-22",
"last_updated": "2022-03-22",
"certification_date": "2022-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "PA",
"license": "MSG014562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.