Individual provider Active NPI

Sadie Marie Malmberg, LMT

  • Massage Therapist
  • Beaumont, TX
National Provider Identifier
1083438253
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT116290 Issued in TX
Practice address
575 18TH St Ste 1
Beaumont, TX 77706-5031
Phone
(409) 626-1811
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 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 MT116290 TX Primary

Addresses

Primary practice location

575 18TH St Ste 1
Beaumont, TX 77706-5031

Mailing address

3560 Delaware St Ste 501
Beaumont, TX 77706-3061
Phone (409) 626-1811

Other practice location 1

3560 Delaware St Ste 501
Beaumont, TX 77706-3061
Phone (409) 626-1811

Other names 1

  • Sadie Oldbury Malmberg Other name

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
MT116290TXMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lymphatic & Massage Studio of Barbara White Massage Therapist CurrentSince Nov 17, 2024 Accepting new patients
Massage Therapy Education Center Massage Therapist PastSince Nov 17, 2024 Accepting new patients

Locations

3560 Delaware St
Ste 501
Beaumont, TX 77706
Phone (409) 347-0554

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": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1083438253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST STE 501",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063061",
            "telephone_number": "409-626-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 18TH ST STE 1",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065031",
            "telephone_number": "409-626-1811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3560 Delaware St Ste 501",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777063061",
            "country_code": "US",
            "telephone_number": "409-626-1811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALMBERG",
        "first_name": "SADIE",
        "middle_name": "MARIE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT116290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SADIE",
            "last_name": "MALMBERG",
            "middle_name": "OLDBURY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.