Donna Heisel – Massage Therapist in Charlo, MT

Key facts

NPI: 1003206814
Entity type: Individual (NPI type 1)
Primary specialty: Massage Therapist 225700000X
License: 330 (MT)
Practice address: 51975 Lost Elk LN
Charlo, MT 59824-9391
Phone: (406) 210-4372
NPI assigned: Feb 1, 2015
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
330	MT	MD	Massage Therapist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Massage Therapist	225700000X	330	MT	Yes

Addresses

Primary practice location

51975 Lost Elk LN
Charlo, MT 59824-9391

Mailing address

51975 Lost Elk LN
Charlo, MT 59824-9391
Phone (406) 210-4372

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2015.

{
    "created_epoch": "1422748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422748800000",
    "number": "1003206814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51975 LOST ELK LN",
            "city": "CHARLO",
            "state": "MT",
            "postal_code": "598249391",
            "telephone_number": "406-210-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51975 LOST ELK LN",
            "city": "CHARLO",
            "state": "MT",
            "postal_code": "598249391",
            "telephone_number": "406-210-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISEL",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-01",
        "last_updated": "2015-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MT",
            "license": "330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlo, MT

All providers in Charlo, MT · Massage Therapist in Montana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.