Active NPI
Amanda Sue Christian, LMT
- Massage Therapist
- Moscow, ID
National Provider Identifier
1053018135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS-4993
- Practice address
- 316 N Main St
Moscow, ID 83843-2629 - Phone
- (208) 892-0318
- NPI assigned
- Feb 9, 2023
- Last updated
- Feb 9, 2023
- 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 | MAS-4993 | ID | Primary |
Addresses
Primary practice location
316 N Main St
Moscow, ID 83843-2629
Mailing address
2990 E Palouse River Dr TRLR 321
Moscow, ID 83843-8869
Phone (208) 596-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MAS-4993 | Other | ID | MASSAGE LICENSE |
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 |
|---|---|---|---|
| MAS-4993 | ID | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1053018135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2990 E PALOUSE RIVER DR TRLR 321",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838438869",
"telephone_number": "208-596-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 N MAIN ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838432629",
"telephone_number": "208-892-0318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIAN",
"first_name": "AMANDA",
"middle_name": "SUE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MAS-4993",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE LICENSE",
"identifier": "MAS-4993",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.