NPIMap

Organization Active NPI

Body Recovery Clinic

  • Reflexologist
  • Cottonwood, AZ
National Provider Identifier
1245500115
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ReflexologistTaxonomy code 173C00000X
Legal business name
BODY RECOVERY CLINIC
Doing business as
Body Recovery Clinic
Practice address
707 E Mingus Ave Ste 504
Body Recovery Clinic
Cottonwood, AZ 86326-6707
Phone
(928) 451-2588
NPI assigned
Jan 9, 2012
Last updated
Apr 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Mrs. Roberta D Russell, LMTNPI 1962782979
Title
Owner
Phone
(928) 451-2588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ReflexologistGroup: 193400000X SINGLE SPECIALTY GROUP 173C00000X Primary
Rehabilitation Clinic/Center 261QR0400X MT-04916 AZ

Addresses

Primary practice location

707 E Mingus Ave Ste 504
Body Recovery Clinic
Cottonwood, AZ 86326-6707

Mailing address

707 E Mingus Ave Ste 504
Body Recovery Clinic
Cottonwood, AZ 86326-6707
Phone (928) 451-2588

Other names 1

  • Body Recovery Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

707 E Mingus Ave
Ste 504
Cottonwood, AZ 86326
Phone (928) 451-2588

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1245500115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MINGUS AVE STE 504",
            "address_2": "BODY RECOVERY CLINIC",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266707",
            "telephone_number": "928-451-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MINGUS AVE STE 504",
            "address_2": "BODY RECOVERY CLINIC",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266707",
            "telephone_number": "928-451-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY RECOVERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-451-2588",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "AZ",
            "license": "MT-04916",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Body Recovery Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.