Individual provider Active NPI

Monica Nicholls

  • Massage Therapist
  • Elk River, MN
National Provider Identifier
1336788108
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
586 Dodge Ave NW Ste D
Elk River, MN 55330-1913
Phone
(952) 454-5903
Fax
(833) 740-1152
NPI assigned
Dec 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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 Primary

Addresses

Primary practice location

586 Dodge Ave NW Ste D
Elk River, MN 55330-1913

Mailing address

7521 Westgate TRL
Eden Prairie, MN 55344-1853
Phone (952) 454-5903

Other practice location 1

12990 Valley View Rd
Eden Prairie, MN 55344-3657
Phone (952) 454-5903

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

NPI Registry JSON

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1336788108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7521 WESTGATE TRL",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553441853",
            "telephone_number": "952-454-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 DODGE AVE NW STE D",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301913",
            "telephone_number": "952-454-5903",
            "fax_number": "833-740-1152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12990 Valley View Rd",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553443657",
            "country_code": "US",
            "telephone_number": "952-454-5903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "MONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.