Brandi Eve Collesides, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

017444 Issued in NY

Practice address

2 Rosell Dr
Ballston Lake, NY 12019-1433

Phone

(518) 663-6000

NPI assigned

Sep 2, 2022

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

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1184344673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CHERYL CT",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121807023",
            "telephone_number": "518-322-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ROSELL DR",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191433",
            "telephone_number": "518-663-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLESIDES",
        "first_name": "BRANDI",
        "middle_name": "EVE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "017444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Ballston Lake, NY
• Providers in Ballston Lake, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.