Individual provider Active NPI

Brooke Martin, MASSAGE THERAPIST

  • Massage Therapist
  • Ephrata, PA
National Provider Identifier
1386192748
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MSG010000 Issued in PA
Practice address
904 Dawn Ave
Ephrata, PA 17522-1340
Phone
(717) 733-8900
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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 MSG010000 PA Primary

Addresses

Primary practice location

904 Dawn Ave
Ephrata, PA 17522-1340

Mailing address

904 Dawn Ave
Ephrata, PA 17522-1340
Phone (717) 733-8900

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
MSG010000PAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1386192748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 DAWN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221340",
            "telephone_number": "717-733-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 DAWN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221340",
            "telephone_number": "717-733-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BROOKE",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "PA",
            "license": "MSG010000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.