Active NPI
Medical Massage, LLC
- Massage Therapist
- Greeley, CO
National Provider Identifier
1366965683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Legal business name
- MEDICAL MASSAGE, LLC
- Practice address
- 2010 21St St
Greeley, CO 80631-6807 - Phone
- (719) 330-9320
- NPI assigned
- Jul 18, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Maki Wada
- Title
- Director/Owner
- Phone
- (719) 330-9320
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
2010 21St St
Greeley, CO 80631-6807
Mailing address
2010 21St St
Greeley, CO 80631-6807
Phone (719) 330-9320
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Massage Therapist
- Greeley, CO
- NPI 1720428774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500336000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1639958400000",
"number": "1366965683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 21ST ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806316807",
"telephone_number": "719-330-9320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 21ST ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806316807",
"telephone_number": "719-330-9320"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL MASSAGE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-07-18",
"last_updated": "2021-12-20",
"certification_date": "2021-12-20",
"status": "A",
"authorized_official_last_name": "WADA",
"authorized_official_first_name": "MAKI",
"authorized_official_title_or_position": "DIRECTOR/OWNER",
"authorized_official_telephone_number": "719-330-9320"
},
"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 Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.