Fenton Massage Company

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

FENTON MASSAGE COMPANY

Practice address

1250 N Leroy St
Fenton, MI 48430-2760

Phone

(810) 354-8330

NPI assigned

Feb 21, 2020

Organization subpart

No

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

Authorized official

Name

Trina Christina Molaski

Title

Business Owner

Phone

(810) 354-8330

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1447883053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N LEROY ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302760",
            "telephone_number": "810-354-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 N LEROY ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302760",
            "telephone_number": "810-354-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTON MASSAGE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "MOLASKI",
        "authorized_official_first_name": "TRINA",
        "authorized_official_middle_name": "CHRISTINA",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "810-354-8330"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "833744561",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Vagaro",
            "affiliation": "N",
            "endpointDescription": "Client Software system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1250 N LeRoy St",
            "city": "Fenton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484302760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fenton Family Medicine, P.C.
• Fenton Healthcare LLC
• Fenton Late Hours Clinic
• Fenton Late Hours Clinic II PC
• Fenton Late Hours Clinic PC
• Fenton Medical Center
• Fenton Pharmacy LLC
• Fenton Pharmacy LLC
• Fenton Pharmacy RX Mi LLC
• Fenton Pharmacy RX Mi LLC

• Health Service Clinic/Center in Fenton, MI
• Providers in Fenton, MI by specialty
• Health Service Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.