Individual provider Active NPI

Debbie Ann Berg, MASSAGE THERAPIST

  • Massage Therapist
  • Richland, WA
National Provider Identifier
1114123957
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00012642 Issued in WA
Practice address
515 Catskill St
Richland, WA 99354-2219
Phone
(509) 946-7570
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00012642 WA Primary

Addresses

Primary practice location

515 Catskill St
Richland, WA 99354-2219

Mailing address

515 Catskill St
Richland, WA 99354-2219
Phone (509) 946-7570

Other identifiers 2

IdentifierTypeStateIssuer
128130OtherWALABOR & INDUSTRY ID #
16352GHOtherWAGROUP HEALTH ID #

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

State licenses

LicenseStateTypeSpecialty
MA00012642WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114123957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CATSKILL ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542219",
            "telephone_number": "509-946-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CATSKILL ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542219",
            "telephone_number": "509-946-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "DEBBIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00012642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY ID #",
            "identifier": "128130",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH ID #",
            "identifier": "16352GH",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.