Active NPI
Cory Lyn Costello, BS, LMT, NMT
- Massage Therapist
- Great Falls, MT
National Provider Identifier
1477078244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- LMT-LMT-LIC-10081
- Practice address
- 1601 2ND Ave N Ste 516
Great Falls, MT 59401-3289 - Phone
- (406) 868-6316
- Fax
- (406) 868-6316
- NPI assigned
- Aug 13, 2017
- Sex
- Female
- 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 | LMT-LMT-LIC-10081 | MT | Primary |
Addresses
Primary practice location
1601 2ND Ave N Ste 516
Great Falls, MT 59401-3289
Mailing address
2601 8TH Ave N
Great Falls, MT 59401-2059
Phone (406) 868-6316
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMT-LMT-LIC-10081 | MT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502582400000",
"number": "1477078244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 8TH AVE N",
"city": "GREAT FALLS",
"state": "MT",
"postal_code": "594012059",
"telephone_number": "406-868-6316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 2ND AVE N STE 516",
"city": "GREAT FALLS",
"state": "MT",
"postal_code": "594013289",
"telephone_number": "406-868-6316",
"fax_number": "406-868-6316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "CORY",
"middle_name": "LYN",
"name_prefix": "Ms.",
"credential": "BS, LMT, NMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-13",
"last_updated": "2017-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MT",
"license": "LMT-LMT-LIC-10081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Falls, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.