Active NPI
Amber Gifford, LMT, LST
- Massage Therapist
- Hayden, ID
National Provider Identifier
1366863847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MASG-788
- Practice address
- 1375 E Miles Ave
Hayden, ID 83835-9251 - Phone
- (208) 653-5629
- NPI assigned
- Dec 30, 2013
- Last updated
- Jun 18, 2014
- Sex
- Female
- 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 | MASG-788 | ID | Primary |
Addresses
Primary practice location
1375 E Miles Ave
Hayden, ID 83835-9251
Mailing address
1375 E Miles Ave
Hayden, ID 83835-9251
Phone (208) 653-5629
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 |
|---|---|---|---|
| MASG-788 | ID | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403049600000",
"number": "1366863847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1375 E MILES AVE",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838359251",
"telephone_number": "208-653-5629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1375 E MILES AVE",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838359251",
"telephone_number": "208-653-5629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIFFORD",
"first_name": "AMBER",
"credential": "LMT, LST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-30",
"last_updated": "2014-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MASG-788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayden, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.