Individual provider Active NPI

Ayana Pedrick

  • Massage Therapist
  • Colorado Springs, CO
National Provider Identifier
1104747518
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0005804 Issued in CO
Practice address
2860 S Circle Dr Ste 250
Colorado Springs, CO 80906-4132
Phone
(719) 900-3009
NPI assigned
Jul 22, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 0005804 CO Primary

Addresses

Primary practice location

2860 S Circle Dr Ste 250
Colorado Springs, CO 80906-4132

Mailing address

1716 Lorraine St Apt B2
Colorado Springs, CO 80905-2180

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Plaza Acupuncture and Chiropractic LLC Massage Therapist PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1104747518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 LORRAINE ST APT B2",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809052180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 250",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064132",
            "telephone_number": "719-900-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRICK",
        "first_name": "AYANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "0005804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.