Individual provider Active NPI

Denise Elizabeth Bolanos, LMT

  • Massage Therapist
  • Henderson, NV
National Provider Identifier
1336569508
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
NVMT.6185 Issued in NV
Practice address
6301 Mountain Vista Street
Suite 208
Henderson, NV 89014-2366
Phone
(702) 810-0082
NPI assigned
Apr 25, 2014
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X NVMT.6185 NV Primary

Addresses

Primary practice location

6301 Mountain Vista Street
Suite 208
Henderson, NV 89014-2366

Mailing address

6301 Mountain Vista Street
Suite 208
Henderson, NV 89014-2366
Phone (702) 810-0082

Other names 1

  • Denise E Willer Former name

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

LicenseStateTypeSpecialty
NVMT.6185NVMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Go Ask Denise LLC Massage Therapist CurrentSince Nov 10, 2024 Accepting new patients

Locations

6301 Mountain Vista St
Ste 208
Henderson, NV 89014
Phone (702) 810-0082

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1336569508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 MOUNTAIN VISTA STREET",
            "address_2": "SUITE 208",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142366",
            "telephone_number": "702-810-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 MOUNTAIN VISTA STREET",
            "address_2": "SUITE 208",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142366",
            "telephone_number": "702-810-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "DENISE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NV",
            "license": "NVMT.6185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "WILLER",
            "middle_name": "E",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.