Individual provider Active NPI

Brian W Ahern, LMT

  • Massage Therapist
  • Bridgeport, CT
National Provider Identifier
1881733756
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
003805 Issued in CT
Practice address
423 Jennings Ave
Bridgeport, CT 06610-1107
Phone
(203) 371-2372
Fax
(203) 371-2372
NPI assigned
Feb 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 003805 CT Primary

Addresses

Primary practice location

423 Jennings Ave
Bridgeport, CT 06610-1107

Mailing address

423 Jennings Ave
Bridgeport, CT 06610-1107
Phone (203) 371-2372

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
003805CTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881733756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 JENNINGS AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101107",
            "telephone_number": "203-371-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 JENNINGS AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101107",
            "telephone_number": "203-371-2372",
            "fax_number": "203-371-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHERN",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CT",
            "license": "003805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.