Individual provider Active NPI

Rachael Elizabeth Thompson, C.M.T

  • Massage Therapist
  • South Bend, IN
National Provider Identifier
1366868895
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT20902599 Issued in IN
Practice address
454 S Gladstone Ave
South Bend, IN 46619-2607
Phone
(574) 344-3664
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT20902599 IN Primary

Addresses

Primary practice location

454 S Gladstone Ave
South Bend, IN 46619-2607

Mailing address

454 S Gladstone Ave
South Bend, IN 46619-2607
Phone (574) 287-4481

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
MT20902599INMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1366868895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 S GLADSTONE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466192607",
            "telephone_number": "574-287-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 S GLADSTONE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466192607",
            "telephone_number": "574-344-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "RACHAEL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "C.M.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT20902599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.