Individual provider Active NPI

Peter Ludwig, LMT.

  • Massage Therapist
  • Idaho Falls, ID
National Provider Identifier
1508245713
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MASG-792 Issued in ID
Practice address
2030 Jennie Lee Dr
Idaho Falls, ID 83404-7000
Phone
(208) 529-8600
Fax
(208) 529-0036
NPI assigned
May 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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 MASG-792 ID Primary

Addresses

Primary practice location

2030 Jennie Lee Dr
Idaho Falls, ID 83404-7000

Mailing address

2030 Jennie Lee Dr
Idaho Falls, ID 83404-7000
Phone (208) 529-8600

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
MASG-792IDMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1508245713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 JENNIE LEE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047000",
            "telephone_number": "208-529-8600",
            "fax_number": "208-529-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 JENNIE LEE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047000",
            "telephone_number": "208-529-8600",
            "fax_number": "208-529-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "LMT.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MASG-792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.