Individual provider Active NPI

Rachael Nicole Jo Heisel

  • Massage Therapist
  • Boulder, CO
National Provider Identifier
1376304808
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT0025355 Issued in CO
Practice address
1800 30TH St Ste 119
Boulder, CO 80301-1088
Phone
(303) 444-1171
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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 MT0025355 CO Primary

Addresses

Primary practice location

1800 30TH St Ste 119
Boulder, CO 80301-1088

Mailing address

1700 9TH Ave Apt 6
Longmont, CO 80501-4125
Phone (720) 609-4439

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
MT0025355COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1376304808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 9TH AVE APT 6",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805014125",
            "telephone_number": "720-609-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 30TH ST STE 119",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011088",
            "telephone_number": "303-444-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISEL",
        "first_name": "RACHAEL",
        "middle_name": "NICOLE JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT0025355",
            "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 Jan 22, 2024; 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.