Individual provider Active NPI

Marcus Boyd Stephens, LMT

  • Massage Therapist
  • Salt Lake City, UT
National Provider Identifier
1336921238
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
9431596-4701 Issued in UT
Practice address
1174 E Graystone Way Ste 2
Salt Lake City, UT 84106-2671
Phone
(801) 884-6013
NPI assigned
Oct 17, 2023
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 9431596-4701 UT Primary

Addresses

Primary practice location

1174 E Graystone Way Ste 2
Salt Lake City, UT 84106-2671

Mailing address

5543 S Edgeberry Dr
Murray, UT 84123-7940
Phone (801) 884-6013

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
9431596-4701UTMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1336921238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5543 S EDGEBERRY DR",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841237940",
            "telephone_number": "801-884-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 E GRAYSTONE WAY STE 2",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062671",
            "telephone_number": "801-884-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MARCUS",
        "middle_name": "BOYD",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "UT",
            "license": "9431596-4701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.