Active NPI
Johnathon Eugene Anderson, LMT
- Massage Therapist
- Simsbury, CT
National Provider Identifier
1821376153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 03-059546
- Practice address
- 1606 Hopmeadow St
Simsbury, CT 06070-1448 - Phone
- (860) 806-1509
- NPI assigned
- Aug 3, 2011
- 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 | 03-059546 | CT | Primary |
Addresses
Primary practice location
1606 Hopmeadow St
Simsbury, CT 06070-1448
Mailing address
117 Highland Ave
New Hartford, CT 06057-2026
Phone (860) 605-3312
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 |
|---|---|---|---|
| 03-059546 | CT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1821376153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 HIGHLAND AVE",
"city": "NEW HARTFORD",
"state": "CT",
"postal_code": "060572026",
"telephone_number": "860-605-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 HOPMEADOW ST",
"city": "SIMSBURY",
"state": "CT",
"postal_code": "060701448",
"telephone_number": "860-806-1509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JOHNATHON",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-03",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CT",
"license": "03-059546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simsbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.