NPIMap

Organization Active NPI

Rogue Massage Clinic, LLC

  • Massage Therapist
  • Medford, OR
National Provider Identifier
1386137248
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
21580 Issued in OR
Legal business name
ROGUE MASSAGE CLINIC, LLC
Practice address
3550 National Drive
Medford, OR 97504
Phone
(541) 324-4179
Fax
(541) 879-3025
NPI assigned
Jun 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Makenzie Lauren Hay, LMTNPI 1104294420
Title
Owner
Phone
(541) 324-4179

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 21580 OR Primary

Addresses

Primary practice location

3550 National Drive
Medford, OR 97504

Mailing address

3550 National Drive
Medford, OR 97504
Phone (541) 324-4179

Other names 1

  • Rogue Massage Clinic, LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1386137248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 NATIONAL DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-324-4179",
            "fax_number": "541-879-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 NATIONAL DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-324-4179",
            "fax_number": "541-879-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE MASSAGE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "HAY",
        "authorized_official_first_name": "MAKENZIE",
        "authorized_official_middle_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-324-4179",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "21580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rogue Massage Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rogue Massage Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rogue Massage Clinic, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.