Active NPI
Tyler Virden
- Massage Therapist
- Prescott Valley, AZ
National Provider Identifier
1356127690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 8200 E Jacque Dr
Prescott Valley, AZ 86314-6172 - Phone
- (928) 277-8715
- NPI assigned
- Sep 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
8200 E Jacque Dr
Prescott Valley, AZ 86314-6172
Mailing address
9320 E Serpentine LN
Prescott Valley, AZ 86314-7562
Phone (832) 967-7419
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presscott Pain Center LLC | Massage Therapist | Past | 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": "1693785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693785600000",
"number": "1356127690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9320 E SERPENTINE LN",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863147562",
"telephone_number": "832-967-7419"
},
{
"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": "VIRDEN",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-04",
"last_updated": "2023-09-04",
"certification_date": "2023-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Sep 4, 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.