Individual provider Active NPI

Guthrie Bridge, CMT

  • Massage Therapist
  • Santa Rosa, CA
National Provider Identifier
1457122962
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
92494 Issued in CA
Practice address
2635 Cleveland Ave Ste 3
Santa Rosa, CA 95403-2981
Phone
(707) 239-9224
NPI assigned
Jan 12, 2024
Last updated
Jan 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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 92494 CA Primary

Addresses

Primary practice location

2635 Cleveland Ave Ste 3
Santa Rosa, CA 95403-2981

Mailing address

PO Box 811
Guerneville, CA 95446-0811
Phone (631) 742-7929

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

NPI Registry JSON

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1457122962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 811",
            "city": "GUERNEVILLE",
            "state": "CA",
            "postal_code": "954460811",
            "telephone_number": "631-742-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 CLEVELAND AVE STE 3",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032981",
            "telephone_number": "707-239-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGE",
        "first_name": "GUTHRIE",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "92494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.

Verify at the official NPI Registry.