Individual provider Active NPI

Melody Ann Raquet

  • Massage Therapist
  • Cheyenne, WY
National Provider Identifier
1205441052
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
OL-21-41284 Issued in WY
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, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
21-41284OtherWYCITY LICENSE

Electronic endpoints 3

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
OL-21-41284WYMDMassage Therapist
CO260756WYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Care Chiropractic, P.C. PastSince Sep 13, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.