Active NPI
Mary Ann McMichael, CHP, LMT
- Massage Therapist
- Omaha, NE
National Provider Identifier
1043829120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3759
- Practice address
- 12305 Gold St Ste 9
Omaha, NE 68144-2760 - Phone
- (402) 672-8738
- NPI assigned
- Jul 24, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 3759 | NE | Primary |
Addresses
Primary practice location
12305 Gold St Ste 9
Omaha, NE 68144-2760
Mailing address
12305 Gold St Ste 9
Omaha, NE 68144-2760
Phone (402) 672-8738
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3759 | Other | NE | LMT LICENSE |
| 3029 | Other | NE | LMT ESTABLISHMENT LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Omaha | Other | |
| CONNECT URL | Omaha | Other |
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 |
|---|---|---|---|
| 3759 | NE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1043829120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12305 GOLD ST STE 9",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442760",
"telephone_number": "402-672-8738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12305 GOLD ST STE 9",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442760",
"telephone_number": "402-672-8738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMICHAEL",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "CHP, LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-24",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NE",
"license": "3759",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMT LICENSE",
"identifier": "3759",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMT ESTABLISHMENT LICENSE",
"identifier": "3029",
"state": "NE"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Omaha",
"affiliation": "N",
"endpointDescription": "www.integratedbodydynamics.com",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Omaha",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "web page",
"address_1": "12305 Gold St Ste 9",
"city": "Omaha",
"state": "NE",
"country_code": "US",
"postal_code": "681442760",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Omaha",
"affiliation": "N",
"endpointDescription": "website",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Omaha",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Omaha",
"address_1": "12305 Gold St Ste 9",
"city": "Omaha",
"state": "NE",
"country_code": "US",
"postal_code": "681442760",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.