Individual provider Active NPI

Marley Marina Hawkins, LMT

  • Massage Therapist
  • Boulder, CO
National Provider Identifier
1497415954
Registry record updated Dec 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT.0023467 Issued in CO
Practice address
2515 Broadway St
Boulder, CO 80304-4110
Phone
(720) 509-9588
NPI assigned
Dec 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2021

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 MT.0023467 CO Primary

Addresses

Primary practice location

2515 Broadway St
Boulder, CO 80304-4110

Mailing address

7435 Mount Sherman Rd
Longmont, CO 80503-8678
Phone (815) 761-8566

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
MT.0023467COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Body Balance Acupuncture Clinic, LLC Massage Therapist CurrentSince Jan 2, 2022 Accepting new patients

Locations

2515 Broadway St
Boulder, CO 80304
Phone (303) 209-5115

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": "1640476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640476800000",
    "number": "1497415954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 MOUNT SHERMAN RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805038678",
            "telephone_number": "815-761-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044110",
            "telephone_number": "720-509-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "MARLEY",
        "middle_name": "MARINA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-26",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0023467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; 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.