Active NPI
Gina Michelle
- Massage Therapist
- Fort Collins, CO
National Provider Identifier
1336539790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7985
- Practice address
- 300 Boardwalk Dr
#6A
Fort Collins, CO 80525-3070 - Phone
- (720) 320-7789
- NPI assigned
- Jan 23, 2015
- Last updated
- Jan 23, 2015
- 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 | 7985 | CO | Primary |
Addresses
Primary practice location
300 Boardwalk Dr
#6A
Fort Collins, CO 80525-3070
Mailing address
370 Circle Dr
Fort Collins, CO 80524-4172
Phone (720) 320-7789
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 |
|---|---|---|---|
| 7985 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421971200000",
"number": "1336539790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 CIRCLE DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805244172",
"telephone_number": "720-320-7789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BOARDWALK DR",
"address_2": "#6A",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253070",
"telephone_number": "720-320-7789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELLE",
"first_name": "GINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-23",
"last_updated": "2015-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "7985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.