Active NPI
John Andrew Wilson
- Massage Therapist
- Denver, CO
National Provider Identifier
1639728116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT.0017543
- Practice address
- 4022 Tennyson St
Denver, CO 80212-2104 - Phone
- (303) 435-8326
- NPI assigned
- Sep 8, 2019
- 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 | MT.0017543 | CO | Primary |
Addresses
Primary practice location
4022 Tennyson St
Denver, CO 80212-2104
Mailing address
4022 Tennyson St
Denver, CO 80212-2104
Phone (303) 435-8326
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 |
|---|---|---|---|
| MT.0017543 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567900800000",
"number": "1639728116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4022 TENNYSON ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802122104",
"telephone_number": "303-435-8326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4022 TENNYSON ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802122104",
"telephone_number": "303-435-8326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JOHN",
"middle_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-08",
"last_updated": "2019-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT.0017543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.