Active NPI
Sonimarie H Montgomery
- Massage Therapist
- Coos Bay, OR
National Provider Identifier
1003389248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13215
- Practice address
- 2590 Woodland Dr
Coos Bay, OR 97420-2050 - Phone
- (503) 330-1715
- Fax
- (541) 808-0399
- NPI assigned
- Jan 10, 2019
- Sex
- Female
- 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 | 13215 | OR | Primary |
Addresses
Primary practice location
2590 Woodland Dr
Coos Bay, OR 97420-2050
Mailing address
95041 Stock Slough LN
Coos Bay, OR 97420-6348
Phone (503) 330-1715
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 |
|---|---|---|---|
| 13215 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1003389248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95041 STOCK SLOUGH LN",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974206348",
"telephone_number": "503-330-1715",
"fax_number": "541-808-0399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2590 WOODLAND DR",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202050",
"telephone_number": "503-330-1715",
"fax_number": "541-808-0399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "SONIMARIE",
"middle_name": "H",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "13215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.