Active NPI
Bruce Vaught, LMT
- Massage Therapist
- Mesa, AZ
National Provider Identifier
1104470285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 24762
- Practice address
- 4135 S Power Rd Ste 110
Mesa, AZ 85212-3625 - Phone
- (623) 326-0545
- NPI assigned
- Jul 28, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 24762 | AZ | Primary |
Addresses
Primary practice location
4135 S Power Rd Ste 110
Mesa, AZ 85212-3625
Mailing address
4202 E Broadway Rd Unit 135
Mesa, AZ 85206-1067
Phone (623) 326-0545
Other practice location 1
6671 E Baseline Rd Ste 126
Mesa, AZ 85206-4328
Phone (623) 326-0545
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744329600000",
"number": "1104470285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4202 E BROADWAY RD UNIT 135",
"city": "MESA",
"state": "AZ",
"postal_code": "852061067",
"telephone_number": "623-326-0545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4135 S POWER RD STE 110",
"city": "MESA",
"state": "AZ",
"postal_code": "852123625",
"telephone_number": "623-326-0545"
}
],
"practiceLocations": [
{
"address_1": "6671 E Baseline Rd Ste 126",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852064328",
"country_code": "US",
"telephone_number": "623-326-0545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAUGHT",
"first_name": "BRUCE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-28",
"last_updated": "2025-04-11",
"certification_date": "2025-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AZ",
"license": "24762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.