Active NPI
Edelyn Prepose Saloom
- Massage Therapist
- Monahans, TX
National Provider Identifier
1043021124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT136559
- Practice address
- 1510 E Sealy Ave
Monahans, TX 79756-4050 - Phone
- (503) 580-4713
- NPI assigned
- Jan 16, 2025
- Last updated
- Jan 16, 2025
- 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 | MT136559 | TX | Primary |
Addresses
Primary practice location
1510 E Sealy Ave
Monahans, TX 79756-4050
Mailing address
1208 Harrison Dr
Kermit, TX 79745-4904
Phone (503) 580-4713
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 |
|---|---|---|---|
| MT136559 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1043021124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1208 HARRISON DR",
"city": "KERMIT",
"state": "TX",
"postal_code": "797454904",
"telephone_number": "503-580-4713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 E SEALY AVE",
"city": "MONAHANS",
"state": "TX",
"postal_code": "797564050",
"telephone_number": "503-580-4713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALOOM",
"first_name": "EDELYN",
"middle_name": "PREPOSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-16",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT136559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monahans, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.