Individual provider Active NPI

Tracy Lynne Miller, MT

  • Massage Therapist
  • Woodbury, MN
National Provider Identifier
1396523080
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
1740 Weir Dr Ste 24
Woodbury, MN 55125-2282
Phone
(651) 232-6830
Fax
(651) 702-2636
NPI assigned
Sep 15, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 8415 NM
Massage Therapist 225700000X NU Primary

Addresses

Primary practice location

1740 Weir Dr Ste 24
Woodbury, MN 55125-2282

Mailing address

374 Summer LN
Maplewood, MN 55117-2335
Phone (505) 501-0687

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
8415NMMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Care Management, PLLC CurrentSince Sep 17, 2023 Accepting new patients

Locations

1740 Weir Dr
Ste 24
Woodbury, MN 55125
Phone (651) 232-6830

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1396523080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 SUMMER LN",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551172335",
            "telephone_number": "505-501-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 WEIR DR STE 24",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252282",
            "telephone_number": "651-232-6830",
            "fax_number": "651-702-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TRACY",
        "middle_name": "LYNNE",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "8415",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.