Active NPI
Leanna Suzette Johnson Blackburn
- Massage Therapist
- Columbus, OH
National Provider Identifier
1609380476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 33.017176
- Practice address
- 5424 W Broad St
Columbus, OH 43228-1155 - Phone
- (614) 870-7288
- Fax
- (614) 870-7288
- NPI assigned
- Nov 30, 2017
- 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 | 33.017176 | OH | Primary |
Addresses
Primary practice location
5424 W Broad St
Columbus, OH 43228-1155
Mailing address
3100 Lewis Rd
Columbus, OH 43207-3701
Phone (614) 632-0529
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 |
|---|---|---|---|
| 33.017176 | OH | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515888000000",
"number": "1609380476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 LEWIS RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432073701",
"telephone_number": "614-632-0529",
"fax_number": "614-350-8708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5424 W BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432281155",
"telephone_number": "614-870-7288",
"fax_number": "614-870-7288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON BLACKBURN",
"first_name": "LEANNA",
"middle_name": "SUZETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-30",
"last_updated": "2018-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OH",
"license": "33.017176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.