Michael Gabriel Johnson

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT107482 Issued in TX

Practice address

7405 Buttonwood Dr
Fort Worth, TX 76137-1308

Phone

(817) 353-4961

NPI assigned

Mar 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1790288447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 TRACE RIDGE PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761375913",
            "telephone_number": "817-353-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 BUTTONWOOD DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761371308",
            "telephone_number": "817-353-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "GABRIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT104482",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT107482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark I Johnson, OTR
• Mary Agnes Johnson, NP
• Meagan Anne Johnson, PA-C
• Melinda D Johnson, O.D.
• Melvin Johnson
• Michael Howard Johnson, PA-C
• Michelle Laurane Johnson, NP-C
• Mitchell Johnson
• Mitzie Johnson, LVN
• Morgan Drew Johnson, LMSW

• Massage Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.