Active NPI
Mancehelen Tisdall Daniel, LMT
- Massage Therapist
- Loveland, CO
National Provider Identifier
1306489992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT0020165
- Practice address
- 4207 N County Road 27 Apt E
Loveland, CO 80538-9460 - Phone
- (970) 776-0597
- NPI assigned
- Oct 25, 2019
- Sex
- Female
- 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 | MT0020165 | CO | Primary |
Addresses
Primary practice location
4207 N County Road 27 Apt E
Loveland, CO 80538-9460
Mailing address
4207 N County Road 27 Apt E
Loveland, CO 80538-9460
Phone (970) 776-0597
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 |
|---|---|---|---|
| MT0020165 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571961600000",
"number": "1306489992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 N COUNTY ROAD 27 APT E",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805389460",
"telephone_number": "970-776-0597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4207 N COUNTY ROAD 27 APT E",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805389460",
"telephone_number": "970-776-0597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIEL",
"first_name": "MANCEHELEN",
"middle_name": "TISDALL",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-25",
"last_updated": "2019-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT0020165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loveland, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.