Active NPI
Matthew David Simons, LMT
- Massage Therapist
- Salt Lake City, UT
National Provider Identifier
1417704735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12923502-4701
- Practice address
- 370 S 300 E
Salt Lake City, UT 84111-3370 - Phone
- (603) 340-1407
- NPI assigned
- May 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 12923502-4701 | UT | Primary |
Addresses
Primary practice location
370 S 300 E
Salt Lake City, UT 84111-3370
Mailing address
1208 S Lake St
Salt Lake City, UT 84105-1222
Phone (603) 340-1407
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12923502-4701 | UT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1417704735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1208 S LAKE ST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841051222",
"telephone_number": "603-340-1407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 S 300 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841113370",
"telephone_number": "603-340-1407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONS",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-03",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "UT",
"license": "12923502-4701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.