Organization Active NPI

Embody Co-Op

  • Massage Therapist
  • Colorado Springs, CO
National Provider Identifier
1487475414
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
EMBODY CO-OP
Practice address
2860 S Circle Dr Ste 250I
Colorado Springs, CO 80906-4113
Phone
(719) 505-5174
NPI assigned
Oct 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Johnathon Brandon Stakely, CMTNPI 1891473286
Title
Massage Therapist
Phone
(719) 505-5174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

2860 S Circle Dr Ste 250I
Colorado Springs, CO 80906-4113

Mailing address

2860 S Circle Dr Ste 250I
Colorado Springs, CO 80906-4113
Phone (719) 505-5174

National Provider Directory

National Provider Directory

Locations

2860 S Circle Dr
Ste 250I
Colorado Springs, CO 80906
Phone (719) 428-7020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1487475414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 250I",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064113",
            "telephone_number": "719-505-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 250I",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064113",
            "telephone_number": "719-505-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODY CO-OP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "STAKELY",
        "authorized_official_first_name": "JOHNATHON",
        "authorized_official_middle_name": "BRANDON",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "719-505-5174",
        "authorized_official_credential": "CMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.