Active NPI
Cody Holland
- Massage Therapist
- Lacey, WA
National Provider Identifier
1386146454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60813390
- Practice address
- 5600 Pacific Ave SE
Lacey, WA 98503-1258 - Phone
- (360) 493-2000
- NPI assigned
- Mar 5, 2018
- Sex
- Male
- 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 | MA60813390 | WA | Primary |
Addresses
Primary practice location
5600 Pacific Ave SE
Lacey, WA 98503-1258
Mailing address
515 4TH Ave SW
Tumwater, WA 98512-6522
Phone (360) 485-6865
Other practice location 1
703 Lilly Rd NE Ste 102
Olympia, WA 98506-5191
Phone (360) 485-6865
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 |
|---|---|---|---|
| MA60813390 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenneth W Trapp DC Inc | Past | Accepting new patients | |
| Vert. Fitness & Wellness Center, LLC | Past | Accepting new patients |
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.
-
- Chiropractor
- Lacey, WA
- NPI 1508980293
-
- Chiropractor
- Lacey, WA
- NPI 1699330373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1386146454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 4TH AVE SW",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985126522",
"telephone_number": "360-485-6865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5600 PACIFIC AVE SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985031258",
"telephone_number": "360-493-2000"
}
],
"practiceLocations": [
{
"address_1": "703 Lilly Rd NE Ste 102",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985065191",
"country_code": "US",
"telephone_number": "360-485-6865",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLAND",
"first_name": "CODY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-05",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60813390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.