NPIMap

Organization Active NPI

Untapped Health LLC

  • Massage Therapist
  • Idaho Falls, ID
National Provider Identifier
1104550102
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
UNTAPPED HEALTH LLC
Practice address
1800 E 17TH St
Idaho Falls, ID 83404-6468
Phone
(208) 252-5770
NPI assigned
Jul 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Authorized official

Name
Justin T OdellNPI 1598376097
Title
Owner Therapist
Phone
(208) 351-2114

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 TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

1800 E 17TH St
Idaho Falls, ID 83404-6468

Mailing address

1800 E 17TH St
Idaho Falls, ID 83404-6468
Phone (208) 252-5770

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL idahofalls@untappedhealthcollege.com Direct

National Provider Directory

National Provider Directory

Locations

1800 E 17th St
Idaho Falls, ID 83404
Phone (208) 252-5770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1104550102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046468",
            "telephone_number": "208-252-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046468",
            "telephone_number": "208-252-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNTAPPED HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "ODELL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER THERAPIST",
        "authorized_official_telephone_number": "208-351-2114"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "idahofalls@untappedhealthcollege.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 E 17th St",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834046468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.