NPIMap

Organization Active NPI

Mesa Body Therapy, LLC

  • Clinic/Center
  • Rocheport, MO
National Provider Identifier
1013530252
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MESA BODY THERAPY, LLC
Practice address
97 Pike St
Rocheport, MO 65279-9392
Phone
(573) 489-6383
NPI assigned
May 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Authorized official

Name
Tawnee Benner, LMTNPI 1588287726
Title
Member
Phone
(573) 489-6383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

97 Pike St
Rocheport, MO 65279-9392

Mailing address

PO Box 45
Rocheport, MO 65279-0045

Other names 1

  • Mesa Body Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1013530252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45",
            "city": "ROCHEPORT",
            "state": "MO",
            "postal_code": "652790045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 PIKE ST",
            "city": "ROCHEPORT",
            "state": "MO",
            "postal_code": "652799392",
            "telephone_number": "573-489-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA BODY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "BENNER",
        "authorized_official_first_name": "TAWNEE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "573-489-6383",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Body Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocheport, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.