Active NPI
Noah Ramm Broome
- Massage Therapist
- Pueblo, CO
National Provider Identifier
1073059002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT0019702
- Practice address
- 117 W 6TH St
Pueblo, CO 81003-3119 - Phone
- (719) 543-6400
- Fax
- (719) 543-1464
- NPI assigned
- Jan 14, 2017
- Last updated
- Jan 14, 2017
- Sex
- Male
- 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 | MT0019702 | CO | Primary |
Addresses
Primary practice location
117 W 6TH St
Pueblo, CO 81003-3119
Mailing address
117 W 6TH St
Pueblo, CO 81003-3119
Phone (719) 543-6400
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 |
|---|---|---|---|
| MT0019702 | CO | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orange Skye Spa | Massage Therapist | Past | Accepting new patients |
| Belezza, LLC | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484352000000",
"number": "1073059002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 W 6TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033119",
"telephone_number": "719-543-6400",
"fax_number": "719-543-1464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 W 6TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033119",
"telephone_number": "719-543-6400",
"fax_number": "719-543-1464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOME",
"first_name": "NOAH",
"middle_name": "RAMM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-14",
"last_updated": "2017-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT0019702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.