Individual provider Active NPI

Damaris Summo, LMT

  • Massage Therapist
  • Cornwall on Hudson, NY
National Provider Identifier
1083437719
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
018758--01 Issued in NY
Practice address
45 Academy Ave
Cornwall on Hudson, NY 12520-1340
Phone
(845) 863-3009
NPI assigned
Nov 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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 018758--01 NY Primary

Addresses

Primary practice location

45 Academy Ave
Cornwall on Hudson, NY 12520-1340

Mailing address

45 Academy Ave
Cornwall on Hudson, NY 12520-1340
Phone (845) 863-3009

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
018758--01NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kneading Time, LLC Massage Therapist CurrentSince Nov 3, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1083437719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ACADEMY AVE",
            "city": "CORNWALL ON HUDSON",
            "state": "NY",
            "postal_code": "125201340",
            "telephone_number": "845-863-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ACADEMY AVE",
            "city": "CORNWALL ON HUDSON",
            "state": "NY",
            "postal_code": "125201340",
            "telephone_number": "845-863-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMO",
        "first_name": "DAMARIS",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "018758--01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornwall on Hudson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.