Active NPI
Cynthia Louise Odell, LMT
- Massage Therapist
- Grants Pass, OR
National Provider Identifier
1326220096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12368
- Practice address
- 141 SW G St.
Grants Pass, OR 97526 - Phone
- (541) 660-8787
- Fax
- (541) 479-4643
- NPI assigned
- Dec 4, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 000865 | CO | |
| Massage Therapist | 225700000X | 12368 | OR | Primary |
Addresses
Primary practice location
141 SW G St.
Grants Pass, OR 97526
Mailing address
315 West Evans Creek Rd # 71
Rogue River, OR 97537
Phone (541) 660-8787
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 |
|---|---|---|---|
| 000865 | CO | MD | Nutritionist |
| 12368 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1326220096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 WEST EVANS CREEK RD # 71",
"city": "ROGUE RIVER",
"state": "OR",
"postal_code": "97537",
"telephone_number": "541-660-8787",
"fax_number": "541-479-4643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 SW G ST.",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "97526",
"telephone_number": "541-660-8787",
"fax_number": "541-479-4643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODELL",
"first_name": "CYNTHIA",
"middle_name": "LOUISE",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "CO",
"license": "000865",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "12368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.