Anna Tidwell, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501005347 Issued in MI

Practice address

6076 Lahring Rd
Linden, MI 48451-8610

Phone

(810) 625-6378

NPI assigned

Oct 31, 2018

Last updated

Oct 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Anna Fletcher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1225505902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6076 LAHRING RD",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518610",
            "telephone_number": "810-625-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6076 LAHRING RD",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518610",
            "telephone_number": "810-625-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "ANNA",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501005347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "FLETCHER",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Therapy Support Services LLC
• Thomas H. Smith, DC PC
• Shantae T Thompson
• Tracie Renee Thompson, COTA/L
• Gregory Scott Thornhill
• Total Wellness Chiropractic, Inc.
• Town Center Family Dental Linden PLLC (Town Center Family Dental Linden)
• Mark E Vogel, PHD
• Nicole Wax
• Linda C Welch, PTA

• Massage Therapist in Linden, MI
• Providers in Linden, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.