Individual provider Active NPI

Dianna R Tait, LMT, BCTMB

  • Massage Therapist
  • Ypsilanti, MI
National Provider Identifier
1013227560
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501000286 Issued in MI
Practice address
1888 Ridgeview
Ypsilanti, MI 48198-9490
Phone
(734) 483-6994
Fax
(734) 971-1360
NPI assigned
Oct 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 530489-07 MI
Massage Therapist 225700000X 7501000286 MI Primary

Addresses

Primary practice location

1888 Ridgeview
Ypsilanti, MI 48198-9490

Mailing address

1888 Ridgeview
Ypsilanti, MI 48198-9490
Phone (734) 483-6994

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
530489-07MIMDMassage Therapist
7501000286MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1013227560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1888 RIDGEVIEW",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481989490",
            "telephone_number": "734-483-6994",
            "fax_number": "734-971-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1888 RIDGEVIEW",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481989490",
            "telephone_number": "734-483-6994",
            "fax_number": "734-971-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIT",
        "first_name": "DIANNA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LMT, BCTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "530489-07",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501000286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.