NPIMap

Organization Active NPI

Body Balance Therapeutic Massage

  • Massage Therapist
  • Blacksburg, VA
National Provider Identifier
1083950406
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
BODY BALANCE THERAPEUTIC MASSAGE
Practice address
210 Professional Park Dr SE
Suite 10
Blacksburg, VA 24060
Phone
(540) 605-8751
Fax
(540) 750-4062
NPI assigned
Dec 13, 2012
Last updated
Sep 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Authorized official

Name
Mrs. Carrie E Boucher, LMTNPI 1174814487
Title
Owner, Massage Therapist
Phone
(540) 449-4235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X NU Primary

Addresses

Primary practice location

210 Professional Park Dr SE
Suite 10
Blacksburg, VA 24060

Mailing address

210 Professional Park Dr SE
Suite 10
Blacksburg, VA 24060
Phone (540) 605-8751

National Provider Directory

National Provider Directory
Tax ID family
Body Balance Spa LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

210 Professional Park Dr SE
Ste 10
Blacksburg, VA 24060
Phone (540) 315-8550

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1083950406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 PROFESSIONAL PARK DR SE",
            "address_2": "SUITE 10",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "24060",
            "telephone_number": "540-605-8751",
            "fax_number": "540-750-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 PROFESSIONAL PARK DR SE",
            "address_2": "SUITE 10",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "24060",
            "telephone_number": "540-605-8751",
            "fax_number": "540-750-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY BALANCE THERAPEUTIC MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-13",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "BOUCHER",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER, MASSAGE THERAPIST",
        "authorized_official_telephone_number": "540-449-4235",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.