Active NPI
Justice M Woods, LMT
- Massage Therapist
- Green Bay, WI
National Provider Identifier
1720761463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 17208-146
- Practice address
- 681 Baeten Rd Ste C
Green Bay, WI 54304-4860 - Phone
- (920) 857-0410
- NPI assigned
- Aug 9, 2023
- 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 | 17208-146 | WI | Primary |
Addresses
Primary practice location
681 Baeten Rd Ste C
Green Bay, WI 54304-4860
Mailing address
2826 Viking Dr Apt 2a
Green Bay, WI 54304-5409
Phone (920) 391-1251
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 |
|---|---|---|---|
| 17208-146 | WI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1720761463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2826 VIKING DR APT 2A",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543045409",
"telephone_number": "920-391-1251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "681 BAETEN RD STE C",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543044860",
"telephone_number": "920-857-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "JUSTICE",
"middle_name": "M",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-09",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "17208-146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.