Active NPI
Maxx Quinton Newberry
- Massage Therapist
- Eugene, OR
National Provider Identifier
1215406848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 19616
- Practice address
- 1245 Charnelton St Ste 9
Eugene, OR 97401-6206 - Phone
- (541) 521-4765
- NPI assigned
- Nov 13, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 19616 | OR | Primary |
Addresses
Primary practice location
1245 Charnelton St Ste 9
Eugene, OR 97401-6206
Mailing address
1290 W 5TH Ave
Eugene, OR 97402-4571
Phone (541) 521-4765
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 832167663 | Medicaid | OR |
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 |
|---|---|---|---|
| 19616 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708300800000",
"number": "1215406848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 W 5TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974024571",
"telephone_number": "541-521-4765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1245 CHARNELTON ST STE 9",
"city": "EUGENE",
"state": "OR",
"postal_code": "974016206",
"telephone_number": "541-521-4765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBERRY",
"first_name": "MAXX",
"middle_name": "QUINTON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-13",
"last_updated": "2024-02-19",
"certification_date": "2024-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "19616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "832167663",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
- New Horizon Adult Care Alternatives, Inc (New Horizons In-Home Care)
- New Leaf Hyperbarics Eugnene
- New Summit Behavioral Therapy, LLC
- New Voice Counseling LLC
- Nicole E Newall, MSW
- Carla B. Newbre, M.S.W.
- Virginia Alice Newby, M.A., QMHP
- Chelsey Ann Newcomb, LMT
- Jessica Newell, BS, CSCS, NTP, RWP
- Zachary Newell, LMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.