Daniel Rodgers, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAT-15158 Issued in HI

Practice address

161 Maa St
Kahului, HI 96732-3603

Phone

(808) 270-1893

Fax

(808) 270-1892

NPI assigned

Jul 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1407428683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MAA ST",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967323603",
            "telephone_number": "808-270-1893",
            "fax_number": "808-270-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MAA ST",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967323603",
            "telephone_number": "808-270-1893",
            "fax_number": "808-270-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "DANIEL",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "MAT-15158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF HAWAII",
            "identifier": "MAT-15158",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@infinityrevive.com",
            "affiliation": "N",
            "endpointDescription": "Website Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "161 Maa St",
            "city": "Kahului",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967323603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Massage Therapist in Kahului, HI
• Providers in Kahului, HI by specialty
• Massage Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.