Individual provider Active NPI

Marshall Payne

  • Massage Therapist
  • Santa Cruz, CA
National Provider Identifier
1336597517
Registry record updated Aug 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
37464 Issued in CA
Practice address
545 Frederick St
Santa Cruz, CA 95062-2635
Phone
(831) 824-4591
NPI assigned
May 29, 2016
Last updated
Aug 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2016

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 37464 CA Primary

Addresses

Primary practice location

545 Frederick St
Santa Cruz, CA 95062-2635

Mailing address

545 Frederick St
Santa Cruz, CA 95062-2635

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
37464CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1464480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1336597517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622635",
            "telephone_number": "831-824-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "MARSHALL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-29",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "37464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.

Verify at the official NPI Registry.