Individual provider Active NPI

Patrick Wroblewski, CMT

  • Massage Therapist
  • Boulder, CO
National Provider Identifier
1073903944
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT.003002 Issued in CO
Practice address
1800 30TH St
Sute 201
Boulder, CO 80301-1088
Phone
(303) 335-9795
NPI assigned
Jan 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT.003002 CO Primary

Addresses

Primary practice location

1800 30TH St
Sute 201
Boulder, CO 80301-1088

Mailing address

3270 Sentinel Dr
Boulder, CO 80301-6300
Phone (303) 817-3445

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

LicenseStateTypeSpecialty
MT.003002COMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1073903944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 SENTINEL DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016300",
            "telephone_number": "303-817-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 30TH ST",
            "address_2": "SUTE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011088",
            "telephone_number": "303-335-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WROBLEWSKI",
        "first_name": "PATRICK",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.003002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.