Active NPI
Bernadette Tiffany, PTA, LMT,CFT
- Massage Therapist
- Pueblo, CO
National Provider Identifier
1376885749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT.0006224
- Practice address
- 126 W D St
Suite 100C
Pueblo, CO 81003-3451 - Phone
- (719) 240-3745
- Fax
- (719) 545-2807
- NPI assigned
- Mar 22, 2013
- 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 | MT.0006224 | CO | Primary |
Addresses
Primary practice location
126 W D St
Suite 100C
Pueblo, CO 81003-3451
Mailing address
126 W D St
Suite 100C
Pueblo, CO 81003-3451
Phone (719) 240-3745
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 |
|---|---|---|---|
| MT.0006224 | CO | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myofascial Body Work, LLC | Massage Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Massage Therapist
- Pueblo, CO
- NPI 1427770148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363910400000",
"number": "1376885749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 W D ST",
"address_2": "SUITE 100C",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033451",
"telephone_number": "719-240-3745",
"fax_number": "719-545-2807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 W D ST",
"address_2": "SUITE 100C",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033451",
"telephone_number": "719-240-3745",
"fax_number": "719-545-2807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIFFANY",
"first_name": "BERNADETTE",
"credential": "PTA, LMT,CFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-22",
"last_updated": "2013-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT.0006224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.