Optimum Performance Therapeutic Massage & Bodywork LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

OPTIMUM PERFORMANCE THERAPEUTIC MASSAGE & BODYWORK LLC

Practice address

325 Main St S
Southbury, CT 06488-4230

Phone

(203) 707-1013

Fax

(203) 405-1798

NPI assigned

Sep 25, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Gassner, LMT, CLTNPI 1023655693

Title

Owner

Phone

(203) 707-1013

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Gassner, LMT, CLT

  • Massage Therapist
  • Southbury, CT
  • NPI 1023655693
  NPD Authorized official

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1699326298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MAIN ST S",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884230",
            "telephone_number": "203-707-1013",
            "fax_number": "203-405-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAIN ST S",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884230",
            "telephone_number": "203-707-1013",
            "fax_number": "203-405-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PERFORMANCE THERAPEUTIC MASSAGE & BODYWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "GASSNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-707-1013",
        "authorized_official_credential": "LMT, CLT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "009561",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Southbury, CT
• Providers in Southbury, CT by specialty
• Massage Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.