Active NPI
Michelle Renee Matlock, MT
- Massage Therapist
- Owosso, MI
National Provider Identifier
1376889642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 206 Corunna Ave
Owosso, MI 48867-3504 - Phone
- (989) 277-4047
- NPI assigned
- Dec 14, 2012
- 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 | Primary |
Addresses
Primary practice location
206 Corunna Ave
Owosso, MI 48867-3504
Mailing address
206 Corunna Ave
Owosso, MI 48867-3504
Phone (989) 277-4047
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
- Credentials
- Medical Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355443200000",
"number": "1376889642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 CORUNNA AVE",
"city": "OWOSSO",
"state": "MI",
"postal_code": "488673504",
"telephone_number": "989-277-4047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 CORUNNA AVE",
"city": "OWOSSO",
"state": "MI",
"postal_code": "488673504",
"telephone_number": "989-277-4047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOCK",
"first_name": "MICHELLE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-14",
"last_updated": "2012-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owosso, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.