Individual provider Active NPI

Diamond R Sharp, LMT

  • Massage Therapist
  • Prescott Valley, AZ
National Provider Identifier
1356086680
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
24760 Issued in AZ
Practice address
8200 E Jacque Dr
Prescott Valley, AZ 86314-6172
Phone
(928) 277-8715
NPI assigned
May 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 24760 AZ Primary

Addresses

Primary practice location

8200 E Jacque Dr
Prescott Valley, AZ 86314-6172

Mailing address

2894 N Yeibitchai Rd
Prescott, AZ 86305-3996
Phone (928) 848-6286

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.synergywellnessaz.com

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
24760AZMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Presscott Pain Center LLC Massage Therapist PastSince May 8, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1356086680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2894 N YEIBITCHAI RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053996",
            "telephone_number": "928-848-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 E JACQUE DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863146172",
            "telephone_number": "928-277-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "DIAMOND",
        "middle_name": "R",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "24760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.synergywellnessaz.com",
            "affiliation": "N",
            "address_1": "8200 E Jacque Dr",
            "city": "Prescott Valley",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863146172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.