Individual provider Active NPI

Phyllynna Christinna Hurtubise, L.M.T.,

  • Massage Therapist
  • Tulsa, OK
National Provider Identifier
1114250305
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
H2598 Issued in OK
Practice address
4908 S 79TH East Ave
Tulsa, OK 74145-6411
Phone
(918) 770-9913
NPI assigned
Sep 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Peer Specialist 175T00000X
Massage Therapist 225700000X H2598 OK Primary

Addresses

Primary practice location

4908 S 79TH East Ave
Tulsa, OK 74145-6411

Mailing address

4908 S 79TH East Ave
Tulsa, OK 74145-6411
Phone (918) 770-9913

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
H2598OKMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1252281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1114250305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 S 79TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741456411",
            "telephone_number": "918-770-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4908 S 79TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741456411",
            "telephone_number": "918-770-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTUBISE",
        "first_name": "PHYLLYNNA",
        "middle_name": "CHRISTINNA",
        "credential": "L.M.T.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-07",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OK",
            "license": "H2598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.