Individual provider Active NPI

Tina Marie Brown, MT

  • Massage Therapist
  • Noblesville, IN
National Provider Identifier
1396475026
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT21204260 Issued in IN
Practice address
9669 E 146TH St
Noblesville, IN 46060-5005
Phone
(317) 957-9510
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 MT21204260 IN Primary

Addresses

Primary practice location

9669 E 146TH St
Noblesville, IN 46060-5005

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

7979 N Shadeland Ave
Indianapolis, IN 46250-2042
Phone (317) 957-9510

Other practice location 2

11849 Lakeside Dr.
Fishers, IN 46038
Phone (317) 989-8211

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
MT21204260INMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1396475026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 E 146TH ST",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460605005",
            "telephone_number": "317-957-9510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7979 N Shadeland Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502042",
            "country_code": "US",
            "telephone_number": "317-957-9510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11849 Lakeside Dr.",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "46038",
            "country_code": "US",
            "telephone_number": "317-989-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT21204260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.