Active NPI
Amy Dunlap
- Massage Therapist
- Missoula, MT
National Provider Identifier
1053705202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 1112
- Practice address
- 2409 Dearborn Ave
Suite 1
Missoula, MT 59801-7586 - Phone
- (406) 552-7613
- NPI assigned
- Mar 26, 2015
- 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 | 1112 | MT | Primary |
Addresses
Primary practice location
2409 Dearborn Ave
Suite 1
Missoula, MT 59801-7586
Mailing address
4600 Sundown Rd
Missoula, MT 59804-7106
Phone (406) 493-0732
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 |
|---|---|---|---|
| 1112 | MT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427328000000",
"number": "1053705202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 SUNDOWN RD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598047106",
"telephone_number": "406-493-0732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2409 DEARBORN AVE",
"address_2": "SUITE 1",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598017586",
"telephone_number": "406-552-7613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNLAP",
"first_name": "AMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-26",
"last_updated": "2015-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MT",
"license": "1112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.