Individual provider Active NPI

Teresa Piddington, LMP

  • Massage Therapist
  • Bainbridge Island, WA
National Provider Identifier
1285055103
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60415324 Issued in WA
Practice address
164 Knechtel Way NE
Bainbridge Island, WA 98110-2838
Phone
(206) 842-4219
NPI assigned
Dec 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60415324 WA Primary

Addresses

Primary practice location

164 Knechtel Way NE
Bainbridge Island, WA 98110-2838

Mailing address

164 Knechtel Way NE
Bainbridge Island, WA 98110-2838
Phone (206) 842-4219

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
MA60415324WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wellness Center, PLLC PastSince Apr 9, 2018 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.

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1285055103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 KNECHTEL WAY NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102838",
            "telephone_number": "206-842-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 KNECHTEL WAY NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102838",
            "telephone_number": "206-842-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIDDINGTON",
        "first_name": "TERESA",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60415324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.