NPIMap

Organization Active NPI

Momentum Medical Massage and Personal Training, LLC

  • Massage Therapist
  • Sandpoint, ID
National Provider Identifier
1295388536
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
MOMENTUM MEDICAL MASSAGE AND PERSONAL TRAINING, LLC
Practice address
1013 W Lake St
Sandpoint, ID 83864
Phone
(360) 909-3331
NPI assigned
Jul 16, 2019
Last updated
Jul 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Authorized official

Name
Kelly Jo EmersonNPI 1215443668
Title
Owner/Practitioner
Phone
(360) 909-3331

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X NU Primary

Addresses

Primary practice location

1013 W Lake St
Sandpoint, ID 83864

Mailing address

1013 W Lake St
Sandpoint, ID 83864
Phone (360) 909-3331

National Provider Directory

National Provider Directory

Locations

1013 W Lake St
Sandpoint, ID 83864
Phone (360) 909-3331

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": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1295388536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 W LAKE ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "83864",
            "telephone_number": "360-909-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 W LAKE ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "83864",
            "telephone_number": "360-909-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM MEDICAL MASSAGE AND PERSONAL TRAINING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "360-909-3331"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.