Active NPI
Thomas Breitbarth
- Massage Therapist
- Normal, IL
National Provider Identifier
1306255989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.000305
- Practice address
- 1713 Fort Jesse Rd
Suite D
Normal, IL 61761-6208 - Phone
- (309) 862-2225
- Fax
- (309) 862-2229
- NPI assigned
- Aug 7, 2014
- Last updated
- Aug 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.000305 | IL | Primary |
Addresses
Primary practice location
1713 Fort Jesse Rd
Suite D
Normal, IL 61761-6208
Mailing address
1713 Fort Jesse Rd
Suite D
Normal, IL 61761-6208
Phone (309) 862-2225
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
| License | State | Type | Specialty |
|---|---|---|---|
| 227.000305 | IL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zozzaro Group LLC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Normal, IL
- NPI 1568623114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407369600000",
"number": "1306255989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 FORT JESSE RD",
"address_2": "SUITE D",
"city": "NORMAL",
"state": "IL",
"postal_code": "617616208",
"telephone_number": "309-862-2225",
"fax_number": "309-862-2229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1713 FORT JESSE RD",
"address_2": "SUITE D",
"city": "NORMAL",
"state": "IL",
"postal_code": "617616208",
"telephone_number": "309-862-2225",
"fax_number": "309-862-2229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREITBARTH",
"first_name": "THOMAS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-07",
"last_updated": "2014-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.000305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.