Active NPI
Nicole Marie Dewitt, L.M.T.
- Massage Therapist
- Vernonia, OR
National Provider Identifier
1194150565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 16099
- Practice address
- 842 2ND Ave
Vernonia, OR 97064-1008 - Phone
- (971) 409-8443
- NPI assigned
- Sep 4, 2013
- Last updated
- Sep 4, 2013
- 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 | 16099 | OR | Primary |
Addresses
Primary practice location
842 2ND Ave
Vernonia, OR 97064-1008
Mailing address
842 2ND Ave
Vernonia, OR 97064-1008
Phone (971) 409-8443
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16099 | Other | OR | OREGON BOARD OF MASSAGE |
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 |
|---|---|---|---|
| 16099 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378252800000",
"number": "1194150565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "842 2ND AVE",
"city": "VERNONIA",
"state": "OR",
"postal_code": "970641008",
"telephone_number": "971-409-8443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "842 2ND AVE",
"city": "VERNONIA",
"state": "OR",
"postal_code": "970641008",
"telephone_number": "971-409-8443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWITT",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-04",
"last_updated": "2013-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "16099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON BOARD OF MASSAGE",
"identifier": "16099",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vernonia, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.