Active NPI
Suzanne Smith
- Massage Therapist
- Lake City, MI
National Provider Identifier
1316482300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7501005782
- Practice address
- 102 B S. Main St
Lake City, MI 49651 - Phone
- (231) 394-0168
- NPI assigned
- Dec 29, 2016
- 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 | 7501005782 | MI | Primary |
Addresses
Primary practice location
102 B S. Main St
Lake City, MI 49651
Mailing address
PO Box 465
Lake City, MI 49651-0465
Phone (231) 394-0168
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 |
|---|---|---|---|
| 7501005782 | MI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482969600000",
"number": "1316482300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 465",
"city": "LAKE CITY",
"state": "MI",
"postal_code": "496510465",
"telephone_number": "231-394-0168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 B S. MAIN ST",
"city": "LAKE CITY",
"state": "MI",
"postal_code": "49651",
"telephone_number": "231-394-0168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SUZANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-29",
"last_updated": "2016-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MI",
"license": "7501005782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.