Individual provider Active NPI

Melisa Brussel, LMT

  • Massage Therapist
  • Southfield, MI
National Provider Identifier
1366972457
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501008661 Issued in MI
Practice address
29255 Northwestern Hwy Ste 300
Southfield, MI 48034-5742
Phone
(248) 353-1234
Fax
(248) 353-1211
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 7501008661 MI Primary

Addresses

Primary practice location

29255 Northwestern Hwy Ste 300
Southfield, MI 48034-5742

Mailing address

29255 Northwestern Hwy Ste 300
Southfield, MI 48034-5742
Phone (248) 353-1234

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
7501008661MIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ompt Specialists, Inc. CurrentSince Jul 24, 2022 Accepting new patients
Auto & Work Comp Rehab LLC PastSince Jul 24, 2022 Accepting new patients

Locations

29255 Northwestern Hwy
Ste 300
Southfield, MI 48034
Phone (248) 343-1234

Organizations & group practices 2

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366972457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY STE 300",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345742",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY STE 300",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345742",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSSEL",
        "first_name": "MELISA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501008661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.