Individual provider Active NPI

Dariell J Johnson, LMT

  • Massage Therapist
  • Jacksonville, FL
National Provider Identifier
1427755255
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA100608 Issued in FL
Practice address
8705 Perimeter Park Blvd Ste 6
Jacksonville, FL 32216-6353
Phone
(904) 997-1349
NPI assigned
Feb 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 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 MA100608 FL Primary

Addresses

Primary practice location

8705 Perimeter Park Blvd Ste 6
Jacksonville, FL 32216-6353

Mailing address

889 Duskin Dr
Jacksonville, FL 32216-1551
Phone (904) 250-1899

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
MA100608FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shaw Chiropractic LLC CurrentSince Feb 19, 2023 Accepting new patients

Locations

8705 Perimeter Park Blvd
Ste 6
Jacksonville, FL 32216
Phone (904) 613-4378

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1427755255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 DUSKIN DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161551",
            "telephone_number": "904-250-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 PERIMETER PARK BLVD STE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166353",
            "telephone_number": "904-997-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DARIELL",
        "middle_name": "J",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA100608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.