Micha Wunner Wunner, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT22007212 Issued in IN

Practice address

5310 Merchandise Dr
Fort Wayne, IN 46825-5140

Phone

(614) 285-9740

NPI assigned

Mar 29, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1134823685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5043 ASPEN PINE BLVD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430169336",
            "telephone_number": "614-285-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 MERCHANDISE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255140",
            "telephone_number": "614-285-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNNER",
        "first_name": "MICHA WUNNER",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.025342",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT22007212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Julia Elizabeth Wyatt
• Katie Lynn Wyatt, DO

• Massage Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Massage Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.