Individual provider Active NPI

Brandon Trean, BCTMB

  • Massage Therapist
  • Boise, ID
National Provider Identifier
1144812223
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MASG-1124 Issued in ID
Practice address
760 E Warm Springs Ave Ste a
Boise, ID 83712-6459
Phone
(208) 870-9753
NPI assigned
Feb 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 MASG-1124 ID Primary

Addresses

Primary practice location

760 E Warm Springs Ave Ste a
Boise, ID 83712-6459

Mailing address

2144 S Dorothy Ave
Boise, ID 83706-4410
Phone (208) 870-9753

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
MASG-1124IDMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1144812223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 S DOROTHY AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064410",
            "telephone_number": "208-870-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 E WARM SPRINGS AVE STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126459",
            "telephone_number": "208-870-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREAN",
        "first_name": "BRANDON",
        "credential": "BCTMB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MASG-1124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.