Santisouk Prough, CMT

Primary specialty

Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X

License

MT Issued in AZ

Practice address

8278 W Lake Pleasant Pkwy
Peoria, AZ 85382-7441

Phone

(510) 384-5817

NPI assigned

Apr 22, 2024

Last updated

Feb 4, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Saced Trip Massage

  • Nurse Massage Therapist (NMT)
  • Peoria, AZ
  • NPI 1659128460
  NPD

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1306691449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 N 15TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850243625",
            "telephone_number": "510-384-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8278 W LAKE PLEASANT PKWY",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827441",
            "telephone_number": "510-384-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUGH",
        "first_name": "SANTISOUK",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "AZ",
            "license": "MT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Massage Therapist (NMT) in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Nurse Massage Therapist (NMT) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.