Active NPI
Suzanne Avantyr, LMT
- Massage Therapist
- Grand Canyon, AZ
National Provider Identifier
1154640753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA#46073
- Practice address
- 100 State Highway 64
Grand Canyon, AZ 86023 - Phone
- (928) 638-8413
- NPI assigned
- May 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA#46073 | FL | Primary |
Addresses
Primary practice location
100 State Highway 64
Grand Canyon, AZ 86023
Mailing address
PO Box 1941
Grand Canyon, AZ 86023-1941
Phone (928) 890-9734
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA#46073 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1154640753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1941",
"city": "GRAND CANYON",
"state": "AZ",
"postal_code": "860231941",
"telephone_number": "928-890-9734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 STATE HIGHWAY 64",
"city": "GRAND CANYON",
"state": "AZ",
"postal_code": "86023",
"telephone_number": "928-638-8413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVANTYR",
"first_name": "SUZANNE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-21",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA#46073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Canyon, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.