Active NPI
Andrew Justin Anderson, LMT, PTA
- Massage Therapist
- Logan, UT
National Provider Identifier
1346047875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 9634705
- Practice address
- 67 E 100 N
Logan, UT 84321-4624 - Phone
- (435) 512-5256
- NPI assigned
- Mar 3, 2025
- Last updated
- Nov 6, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | 9634705 | UT | Primary |
Addresses
Primary practice location
67 E 100 N
Logan, UT 84321-4624
Mailing address
92 N Center
Newton, UT 84327-0103
Phone (435) 512-5256
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 |
|---|---|---|---|
| 9634705 | UT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762387200000",
"number": "1346047875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 N CENTER",
"city": "NEWTON",
"state": "UT",
"postal_code": "843270103",
"telephone_number": "435-512-5256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 E 100 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "843214624",
"telephone_number": "435-512-5256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ANDREW",
"middle_name": "JUSTIN",
"name_prefix": "Mr.",
"credential": "LMT, PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-03",
"last_updated": "2025-11-06",
"certification_date": "2025-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "UT",
"license": "9634705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.