Individual provider Active NPI

Johanna Isela Valencia, LMT, MLD

  • Massage Therapist
  • New York, NY
National Provider Identifier
1629737127
Registry record updated Dec 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
031849 Issued in NY
Practice address
765 FDR Dr Apt 4D
New York, NY 10009-5617
Phone
(646) 671-4814
NPI assigned
Dec 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2021

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 031849 NY Primary

Addresses

Primary practice location

765 FDR Dr Apt 4D
New York, NY 10009-5617

Mailing address

765 FDR Dr Apt 4D
New York, NY 10009-5617
Phone (646) 671-4814

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
031849NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1639267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639267200000",
    "number": "1629737127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 FDR DR APT 4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100095617",
            "telephone_number": "646-671-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 FDR DR APT 4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100095617",
            "telephone_number": "646-671-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "JOHANNA",
        "middle_name": "ISELA",
        "credential": "LMT, MLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-12",
        "last_updated": "2021-12-12",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "031849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2021; 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.