Individual provider Active NPI

Carolyn Margo Ende

  • Massage Therapist
  • Boulder, CO
National Provider Identifier
1407132905
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
10615 Issued in CO
Practice address
3400 Table Mesa Dr
Suite 203
Boulder, CO 80305-5869
Phone
(303) 499-9892
NPI assigned
Oct 27, 2011
Last updated
Oct 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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 10615 CO Primary

Addresses

Primary practice location

3400 Table Mesa Dr
Suite 203
Boulder, CO 80305-5869

Mailing address

3400 Table Mesa Dr
Suite 203
Boulder, CO 80305-5869
Phone (303) 499-9892

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
10615COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Massage Massage Therapist Past Accepting new patients

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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1407132905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 TABLE MESA DR",
            "address_2": "SUITE 203",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055869",
            "telephone_number": "303-499-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 TABLE MESA DR",
            "address_2": "SUITE 203",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055869",
            "telephone_number": "303-499-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDE",
        "first_name": "CAROLYN",
        "middle_name": "MARGO",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "10615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.