Individual provider Active NPI

Marcella Alice Thompson

  • Massage Therapist
  • Louisville, KY
National Provider Identifier
1396371860
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
248360 Issued in KY
Practice address
5516 Overbrook Woods PL Apt 103
Louisville, KY 40291-5436
Phone
(502) 356-2815
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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 248360 KY Primary

Addresses

Primary practice location

5516 Overbrook Woods PL Apt 103
Louisville, KY 40291-5436

Mailing address

5516 Overbrook Woods PL Apt 103
Louisville, KY 40291-5436
Phone (502) 356-2815

Other identifiers 1

IdentifierTypeStateIssuer
0157786384OtherKYCBI -COMMUNITY BUSINESS IDENTIFIER

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Louisville Direct
CONNECT URL Louisville Direct

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
248360KYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1396371860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5516 OVERBROOK WOODS PL APT 103",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402915436",
            "telephone_number": "502-356-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5516 OVERBROOK WOODS PL APT 103",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402915436",
            "telephone_number": "502-356-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MARCELLA",
        "middle_name": "ALICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "248360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBI -COMMUNITY BUSINESS IDENTIFIER",
            "identifier": "0157786384",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Louisville",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5516 Overbrook Woods Pl Apt 103",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402915436",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Louisville",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5516 Overbrook Woods Pl Apt 103",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402915436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.