Active NPI
Samuel Ray McKay Olson
- Massage Therapist
- Newton, MA
National Provider Identifier
1336962349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 16097
- Practice address
- 383 Elliot St Unit F
Newton, MA 02464-1126 - Phone
- (617) 964-3332
- NPI assigned
- Nov 7, 2024
- Sex
- Male
- Sole proprietor
- No
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 | 16097 | MA | Primary |
Addresses
Primary practice location
383 Elliot St Unit F
Newton, MA 02464-1126
Mailing address
24 Federal St
Millis, MA 02054-1459
Phone (508) 254-4701
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 |
|---|---|---|---|
| 16097 | MA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1336962349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FEDERAL ST",
"city": "MILLIS",
"state": "MA",
"postal_code": "020541459",
"telephone_number": "508-254-4701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "383 ELLIOT ST UNIT F",
"city": "NEWTON",
"state": "MA",
"postal_code": "024641126",
"telephone_number": "617-964-3332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "SAMUEL",
"middle_name": "RAY MCKAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-07",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MA",
"license": "16097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.