Active NPI
David William Dolan, L.M.T.-MASSAGE THERA
- Massage Therapist
- Durango, CO
National Provider Identifier
1205950292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA# 10055
- Practice address
- 575 Rivergate
Suite 95
Durango, CO 81301-7487 - Phone
- (505) 947-0112
- NPI assigned
- Mar 17, 2007
- Sex
- Male
- 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 | MA# 10055 | FL | Primary |
| Massage Therapist | 225700000X | 7499 | CO |
Addresses
Primary practice location
575 Rivergate
Suite 95
Durango, CO 81301-7487
Mailing address
PO Box 2462
Pagosa Springs, CO 81147-2462
Phone (505) 947-0112
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 593341785 | Other | FL | FEIN |
| 7499 | Other | CO | LICENSED MASSAGE THERAPIST |
| MA# 10055 | Other | FL | LIC. MASSAGE THERAPIST |
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 |
|---|---|---|---|
| 7499 | CO | MD | Massage Therapist |
| MA# 10055 | FL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan River Rehabilitation LLC | 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 and National Provider Directory roles.
-
- Massage Therapist
- Pagosa Springs, CO
- NPI 1437418316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268870400000",
"number": "1205950292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2462",
"city": "PAGOSA SPRINGS",
"state": "CO",
"postal_code": "811472462",
"telephone_number": "505-947-0112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 RIVERGATE",
"address_2": "SUITE 95",
"city": "DURANGO",
"state": "CO",
"postal_code": "813017487",
"telephone_number": "505-947-0112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLAN",
"first_name": "DAVID",
"middle_name": "WILLIAM",
"credential": "L.M.T.-MASSAGE THERA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-17",
"last_updated": "2010-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA# 10055",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "7499",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEIN",
"identifier": "593341785",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED MASSAGE THERAPIST",
"identifier": "7499",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIC. MASSAGE THERAPIST",
"identifier": "MA# 10055",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durango, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.