NPIMap

Organization Active NPI

Earth Body Massage

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1346936697
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
EARTH BODY MASSAGE
Practice address
447 NE Greenwood Ave
Bend, OR 97701-4607
Phone
(541) 213-0933
NPI assigned
Apr 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Authorized official

Name
Katelyn Elston, LMTNPI 1588033039
Title
Owner
Phone
(541) 480-7845

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

447 NE Greenwood Ave
Bend, OR 97701-4607

Mailing address

19657 Hiller Dr
Bend, OR 97702-9028
Phone (541) 480-7845

Other names 2

  • Earth Body Massage Doing business as
  • Fade Out Tattoo Removal LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1346936697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19657 HILLER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029028",
            "telephone_number": "541-480-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 NE GREENWOOD AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014607",
            "telephone_number": "541-213-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH BODY MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "ELSTON",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-480-7845",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Earth Body Massage",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fade Out Tattoo Removal LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.