Individual provider Active NPI

Briana Moore

  • Massage Therapist
  • Blaine, MN
National Provider Identifier
1295053346
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
1061 109TH Ave NE
Blaine, MN 55434-3846
Phone
(763) 208-4562
NPI assigned
May 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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 MN Primary

Addresses

Primary practice location

1061 109TH Ave NE
Blaine, MN 55434-3846

Mailing address

11524 Jefferson St NE
Blaine, MN 55434-1805
Phone (612) 619-5316

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

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1295053346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11524 JEFFERSON ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554341805",
            "telephone_number": "612-619-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 109TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343846",
            "telephone_number": "763-208-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.