Active NPI
Sonja A. Stovall
- Massage Therapist
- Fairbanks, AK
National Provider Identifier
1164911905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 124644
- Practice address
- 565 University Ave Ste 1
Fairbanks, AK 99709-3687 - Phone
- (907) 456-8426
- NPI assigned
- May 8, 2018
- 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 | 124644 | AK | Primary |
Addresses
Primary practice location
565 University Ave Ste 1
Fairbanks, AK 99709-3687
Mailing address
PO Box 80205
Fairbanks, AK 99708-0205
Phone (907) 388-4772
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 |
|---|---|---|---|
| 124644 | AK | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1164911905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80205",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997080205",
"telephone_number": "907-388-4772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 UNIVERSITY AVE STE 1",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093687",
"telephone_number": "907-456-8426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVALL",
"first_name": "SONJA",
"middle_name": "A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-08",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AK",
"license": "124644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.