Active NPI
Sandra P. Smith, MASSAGE THERAPIST
- Massage Therapist
- Lannon, WI
National Provider Identifier
1184860256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 731-046
- Practice address
- 20079 West Main Street
Suite B
Lannon, WI 53046 - Phone
- (262) 502-4051
- Fax
- (262) 502-4053
- NPI assigned
- Dec 19, 2008
- Last updated
- Dec 19, 2008
- 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 | 731-046 | WI | Primary |
Addresses
Primary practice location
20079 West Main Street
Suite B
Lannon, WI 53046
Mailing address
P.O. Box 264
20079 West Main Street Suite B
Lannon, WI 53046
Phone (262) 502-4051
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 |
|---|---|---|---|
| 731-046 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Caring Touch by Gary & Sandy | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Massage Therapist
- Lannon, WI
- NPI 1376787309
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229644800000",
"number": "1184860256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 264",
"address_2": "20079 WEST MAIN STREET SUITE B",
"city": "LANNON",
"state": "WI",
"postal_code": "53046",
"telephone_number": "262-502-4051",
"fax_number": "262-502-4053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20079 WEST MAIN STREET",
"address_2": "SUITE B",
"city": "LANNON",
"state": "WI",
"postal_code": "53046",
"telephone_number": "262-502-4051",
"fax_number": "262-502-4053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SANDRA",
"middle_name": "P.",
"name_prefix": "Mrs.",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-19",
"last_updated": "2008-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "731-046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lannon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.