Active NPI
Barry Dean Kurtz
- Massage Therapist
- Meridian, ID
National Provider Identifier
1053716134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MASG-2165
- Practice address
- 3081 S Grimes Creek Ave
Meridian, ID 83642-9125 - Phone
- (208) 288-2264
- NPI assigned
- Oct 31, 2014
- Last updated
- Oct 31, 2014
- Sex
- Male
- 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 | MASG-2165 | ID | Primary |
Addresses
Primary practice location
3081 S Grimes Creek Ave
Meridian, ID 83642-9125
Mailing address
82 E State St
Suite E
Eagle, ID 83616-6047
Phone (208) 440-8648
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 |
|---|---|---|---|
| MASG-2165 | ID | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414713600000",
"number": "1053716134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 E STATE ST",
"address_2": "SUITE E",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166047",
"telephone_number": "208-440-8648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3081 S GRIMES CREEK AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429125",
"telephone_number": "208-288-2264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KURTZ",
"first_name": "BARRY",
"middle_name": "DEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-31",
"last_updated": "2014-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MASG-2165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.