Michelle Ann Fousse, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

018612-1 Issued in NY

Practice address

1215 Mayberry Place
Macedon, NY 14502

Phone

(315) 986-4605

NPI assigned

Jul 6, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043418502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 TIMBERLINE DR",
            "city": "MACEDON",
            "state": "NY",
            "postal_code": "145029120",
            "telephone_number": "585-314-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 MAYBERRY PLACE",
            "city": "MACEDON",
            "state": "NY",
            "postal_code": "14502",
            "telephone_number": "315-986-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUSSE",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "018612-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Dubay, M.S., CCC-SLP
• Jill Wickman Escriva
• Christopher Etterle, MD
• Laura Evans, LMHC
• Roxanne Marie Finney, LPN
• Kaylen Furr, MHC
• Gananda Family Practice
• Gananda Family Practice
• Gananda Walworth Physical Therapy
• Betsy L George-Jones, PT

• All providers in Macedon, NY
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.