Active NPI
Sean Edwards
- Massage Therapist
- Boulder, CO
National Provider Identifier
1356786321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT.0007648
- Practice address
- 3400 Table Mesa Dr
Suite 203
Boulder, CO 80305-5869 - Phone
- (303) 449-9892
- NPI assigned
- May 5, 2013
- 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 | MT.0007648 | CO | Primary |
Addresses
Primary practice location
3400 Table Mesa Dr
Suite 203
Boulder, CO 80305-5869
Mailing address
3400 Table Mesa Dr
Suite 203
Boulder, CO 80305-5869
Phone (303) 449-9892
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 |
|---|---|---|---|
| MT.0007648 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367712000000",
"number": "1356786321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 TABLE MESA DR",
"address_2": "SUITE 203",
"city": "BOULDER",
"state": "CO",
"postal_code": "803055869",
"telephone_number": "303-449-9892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 TABLE MESA DR",
"address_2": "SUITE 203",
"city": "BOULDER",
"state": "CO",
"postal_code": "803055869",
"telephone_number": "303-449-9892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "SEAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-05",
"last_updated": "2013-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT.0007648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.