Individual provider Active NPI

Avrielle Caroline Simoneau, LMT

  • Massage Therapist
  • Bozeman, MT
National Provider Identifier
1467131128
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
LMT-LMT-LIC-25362 Issued in MT
Practice address
1174 Stoneridge Dr Ste 301
Bozeman, MT 59718-9850
Phone
(406) 577-6174
NPI assigned
Jul 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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 LMT-LMT-LIC-25362 MT Primary

Addresses

Primary practice location

1174 Stoneridge Dr Ste 301
Bozeman, MT 59718-9850

Mailing address

315 E Beall St
Bozeman, MT 59715-3623
Phone (406) 577-6174

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
LMT-LMT-LIC-25362MTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sundrop Wellness Massage Therapist Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1467131128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E BEALL ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153623",
            "telephone_number": "406-577-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 STONERIDGE DR STE 301",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189850",
            "telephone_number": "406-577-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONEAU",
        "first_name": "AVRIELLE",
        "middle_name": "CAROLINE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MT",
            "license": "LMT-LMT-LIC-25362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.