Individual provider Active NPI

James W. Porr, MASSAGE THERAPIST

  • Massage Therapist
  • Massapequa, NY
National Provider Identifier
1407621410
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
004754-01 Issued in NY
Practice address
114 Pittsburgh Avenue
Massapequa, NY 11758
Phone
(516) 993-3797
NPI assigned
Nov 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 004754-01 NY Primary

Addresses

Primary practice location

114 Pittsburgh Avenue
Massapequa, NY 11758

Mailing address

114 Pittsburgh Avenue
Massapequa, NY 11758
Phone (516) 993-3797

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
004754-01NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1407621410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 PITTSBURGH AVENUE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-993-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 PITTSBURGH AVENUE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-993-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORR",
        "first_name": "JAMES",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "004754-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.