Active NPI
Justin Wilson
- Massage Therapist
- Boston, MA
National Provider Identifier
1477353183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 18451
- Practice address
- 102 Charles St # Ma
Boston, MA 02114-4607 - Phone
- (703) 232-2517
- NPI assigned
- Mar 13, 2025
- Sex
- Male
- 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 | 18451 | MA | Primary |
Addresses
Primary practice location
102 Charles St # Ma
Boston, MA 02114-4607
Mailing address
139 Washington Ave
Chelsea, MA 02150-3933
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 |
|---|---|---|---|
| 18451 | MA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741824000000",
"number": "1477353183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 WASHINGTON AVE",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021503933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 CHARLES ST # MA",
"city": "BOSTON",
"state": "MA",
"postal_code": "021144607",
"telephone_number": "703-232-2517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-13",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MA",
"license": "18451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.