Active NPI
Keri A. Johnson, L.M.P.
- Massage Therapist
- Port Orchard, WA
National Provider Identifier
1417289117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00015768
- Practice address
- 5155 McCormick Woods Dr SW
Port Orchard, WA 98367-9169 - Phone
- (360) 895-0142
- NPI assigned
- Feb 4, 2010
- Sex
- Female
- 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 | MA00015768 | WA | Primary |
Addresses
Primary practice location
5155 McCormick Woods Dr SW
Port Orchard, WA 98367-9169
Mailing address
6827 Kenfig PL SW
Port Orchard, WA 98367-7620
Phone (206) 755-9679
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 |
|---|---|---|---|
| MA00015768 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265241600000",
"number": "1417289117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6827 KENFIG PL SW",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983677620",
"telephone_number": "206-755-9679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5155 MCCORMICK WOODS DR SW",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983679169",
"telephone_number": "360-895-0142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KERI",
"middle_name": "A.",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-04",
"last_updated": "2010-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00015768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.