Active NPI
David C Johnson, LTM
- Massage Therapist
- Perth Amboy, NJ
National Provider Identifier
1619762085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 375 State St Apt 206
Perth Amboy, NJ 08861-3435 - Phone
- (862) 378-7856
- NPI assigned
- Apr 14, 2025
- Last updated
- Aug 4, 2025
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
375 State St Apt 206
Perth Amboy, NJ 08861-3435
Mailing address
375 State St Apt 206
Perth Amboy, NJ 08861-3435
Phone (862) 378-7856
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corderro Soul Massage | Massage Therapist | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1619762085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 STATE ST APT 206",
"city": "PERTH AMBOY",
"state": "NJ",
"postal_code": "088613435",
"telephone_number": "862-378-7856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 STATE ST APT 206",
"city": "PERTH AMBOY",
"state": "NJ",
"postal_code": "088613435",
"telephone_number": "862-378-7856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DAVID",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LTM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-14",
"last_updated": "2025-08-04",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Perth Amboy, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.