Active NPI
Melody Ann Raquet
- Massage Therapist
- Cheyenne, WY
National Provider Identifier
1205441052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- OL-21-41284
- Practice address
- 7124 Commons Dr Unit D
Cheyenne, WY 82009-2620 - Phone
- (307) 635-6777
- Fax
- (307) 635-6780
- NPI assigned
- Sep 9, 2020
- Last updated
- Sep 9, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | OL-21-41284 | WY | Primary |
| Occupational Therapist | 225X00000X | CO260756 | WY |
Addresses
Primary practice location
7124 Commons Dr Unit D
Cheyenne, WY 82009-2620
Mailing address
7124 Commons Dr Unit D
Cheyenne, WY 82009-2620
Phone (307) 635-6777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21-41284 | Other | WY | CITY LICENSE |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Computer | Health Information Exchange (HIE) | |
| CONNECT URL | Computer | Health Information Exchange (HIE) | |
| Direct Messaging Address | office@activecarechirocheyenne.com | Direct |
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 |
|---|---|---|---|
| OL-21-41284 | WY | MD | Massage Therapist |
| CO260756 | WY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Care Chiropractic, P.C. | Past | Accepting new patients |
Interoperability endpoints
- office@activecarechirocheyenne.com
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.
-
- Chiropractor
- Cheyenne, WY
- NPI 1285881169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1205441052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7124 COMMONS DR UNIT D",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820092620",
"telephone_number": "307-635-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7124 COMMONS DR UNIT D",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820092620",
"telephone_number": "307-635-6777",
"fax_number": "307-635-6780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAQUET",
"first_name": "MELODY",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-09",
"last_updated": "2020-09-09",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WY",
"license": "OL-21-41284",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WY",
"license": "CO260756",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CITY LICENSE",
"identifier": "21-41284",
"state": "WY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Computer",
"affiliation": "N",
"endpointDescription": "Office Receptionists",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7124 Commons Dr Unit D",
"city": "Cheyenne",
"state": "WY",
"country_code": "US",
"postal_code": "820092620",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Computer",
"affiliation": "N",
"endpointDescription": "Office Receptionists",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7124 Commons Dr Unit D",
"city": "Cheyenne",
"state": "WY",
"country_code": "US",
"postal_code": "820092620",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "office@activecarechirocheyenne.com",
"affiliation": "N",
"endpointDescription": "direct e-mail",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7124 Commons Dr Unit D",
"city": "Cheyenne",
"state": "WY",
"country_code": "US",
"postal_code": "820092620",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.