Summer Nichole Blake, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT0016519 Issued in CO

Practice address

1545 Ogden Rd
Montrose, CO 81401-5683

Phone

(404) 395-5026

NPI assigned

Jul 19, 2014

Last updated

Jul 19, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405728000000",
    "number": "1184031361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N STOUGH AVE",
            "address_2": "APARTMENT 1 A",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013770",
            "telephone_number": "404-395-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 OGDEN RD",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015683",
            "telephone_number": "404-395-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "SUMMER",
        "middle_name": "NICHOLE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-19",
        "last_updated": "2014-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT0016519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Montrose, CO
• Providers in Montrose, CO by specialty
• Massage Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2014; 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.