Individual provider Active NPI

Erin Bernice Legros, MASSAGE THERAPIST

  • Massage Therapist
  • Indianapolis, IN
National Provider Identifier
1215258264
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT20903164 Issued in IN
Practice address
740 E 52ND St
Suite 12
Indianapolis, IN 46205-1172
Phone
(317) 921-0972
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Reflexologist 173C00000X MT20903164 IN
Health Educator 174H00000X MT20903164 IN
Massage Therapist 225700000X MT20903164 IN Primary

Addresses

Primary practice location

740 E 52ND St
Suite 12
Indianapolis, IN 46205-1172

Mailing address

622 W 39TH St
Indianapolis, IN 46208-3929
Phone (317) 921-0972

Other identifiers 1

IdentifierTypeStateIssuer
MT20903164OtherININDIANA PROFESSIONAL LICENSING AGENCY

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
MT20903164INMDReflexologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1215258264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 39TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462083929",
            "telephone_number": "317-921-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 E 52ND ST",
            "address_2": "SUITE 12",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051172",
            "telephone_number": "317-921-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGROS",
        "first_name": "ERIN",
        "middle_name": "BERNICE",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "IN",
            "license": "MT20903164",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "IN",
            "license": "MT20903164",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT20903164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL LICENSING AGENCY",
            "identifier": "MT20903164",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.

Verify at the official NPI Registry.