Individual provider Active NPI

Rhydian Blackthorne, LMT

  • Massage Therapist
  • Albuquerque, NM
National Provider Identifier
1467960336
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT8347 Issued in NM
Practice address
4010 Carlisle Blvd NE Ste D
Albuquerque, NM 87107-4532
Phone
(505) 977-0666
NPI assigned
Jan 13, 2018
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 171026 KY
Massage Therapist 225700000X MT8347 NM Primary

Addresses

Primary practice location

4010 Carlisle Blvd NE Ste D
Albuquerque, NM 87107-4532

Mailing address

624 Douglas Macarthur Rd NW
Albuquerque, NM 87107-5138
Phone (505) 977-0666

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
171026KYMDMassage Therapist
MT8347NMMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blackthorne Inc Massage Therapist CurrentSince Jul 2, 2023 Accepting new patients

Locations

231 Sierra Dr SE
Ste 7
Albuquerque, NM 87108
Phone (505) 331-6574

4010 Carlisle Blvd NE
Ste D
Albuquerque, NM 87107
Phone (505) 977-0666

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1515801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1467960336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 DOUGLAS MACARTHUR RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871075138",
            "telephone_number": "505-977-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 CARLISLE BLVD NE STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074532",
            "telephone_number": "505-977-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKTHORNE",
        "first_name": "RHYDIAN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-13",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "171026",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "MT8347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.