Active NPI
Maryann Tidwell, LMT
- Massage Therapist
- Chandler, AZ
National Provider Identifier
1396046306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 10661
- Practice address
- 930 W Warner Rd
Suite 32
Chandler, AZ 85225-1040 - Phone
- (602) 743-4263
- NPI assigned
- Nov 7, 2010
- Last updated
- Dec 2, 2010
- 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 | 10661 | AZ | Primary |
Addresses
Primary practice location
930 W Warner Rd
Suite 32
Chandler, AZ 85225-1040
Mailing address
2104 N Los Altos Dr
Chandler, AZ 85224-2135
Phone (602) 743-4263
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291248000000",
"number": "1396046306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 N LOS ALTOS DR",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852242135",
"telephone_number": "602-743-4263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 W WARNER RD",
"address_2": "SUITE 32",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852251040",
"telephone_number": "602-743-4263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDWELL",
"first_name": "MARYANN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-07",
"last_updated": "2010-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AZ",
"license": "10661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.