Individual provider Active NPI

Johnie McMahon

  • Massage Therapist
  • Iowa City, IA
National Provider Identifier
1679238893
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
095071 Issued in IA
Practice address
1130 S Scott Blvd Ste 1
Iowa City, IA 52240-2909
Phone
(319) 354-2429
Fax
(319) 354-6100
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 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 095071 IA Primary

Addresses

Primary practice location

1130 S Scott Blvd Ste 1
Iowa City, IA 52240-2909

Mailing address

1130 S Scott Blvd Ste 1
Iowa City, IA 52240-2909
Phone (319) 354-2429

Other identifiers 1

IdentifierTypeStateIssuer
06-65463MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmcmahon@praiowa.com Direct

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
095071IAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Rehabilitation Associates L.L.C. CurrentSince Mar 26, 2023 Accepting new patients
Premier Physical Therapy of Iowa CurrentSince Oct 29, 2023 Accepting new patients

Locations

1130 S Scott Blvd
Ste 1
Iowa City, IA 52240
Phone (319) 354-2429

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1679238893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S SCOTT BLVD STE 1",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402909",
            "telephone_number": "319-354-2429",
            "fax_number": "319-354-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S SCOTT BLVD STE 1",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402909",
            "telephone_number": "319-354-2429",
            "fax_number": "319-354-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "JOHNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IA",
            "license": "095071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06-65463",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcmahon@praiowa.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1130 S Scott Blvd Ste 1",
            "city": "Iowa City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "522402909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.