Olivia Binkowska, CMT, RYT

Key facts

NPI

1093477945

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

88173 (CA)

Practice address

6771 Elm Ave
San Bernardino, CA 92404-5740

Phone

(909) 333-8769

NPI assigned

Oct 7, 2021

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 7, 2021.

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1093477945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6771 ELM AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045740",
            "telephone_number": "909-333-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6771 ELM AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045740",
            "telephone_number": "909-333-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINKOWSKA",
        "first_name": "OLIVIA",
        "credential": "CMT, RYT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "88173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "YOGA ALLIANCE",
            "identifier": "329451",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAMTC",
            "identifier": "88173",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.resiliencemassage.amtamembers.com",
            "affiliation": "N",
            "endpointDescription": "personal website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "personal website",
            "address_1": "6771 Elm Ave",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924045740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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