Thomas Robert Divis, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60706487 Issued in WA

Practice address

15436 Bel Red Rd
Redmond, WA 98052-5536

Phone

(206) 267-0814

NPI assigned

Feb 28, 2018

Last updated

Feb 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gina M Wolf DC PS

  • Chiropractor
  • Spokane Valley, WA
  • NPI 1205055902
  NPD (past)

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1508368127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16255 NE 27TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082209",
            "telephone_number": "509-322-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15436 BEL RED RD",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525536",
            "telephone_number": "206-267-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVIS",
        "first_name": "THOMAS",
        "middle_name": "ROBERT",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60706487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Joseph Dillon, DDS
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• Doris Djorgee I
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• Jared William Doak

• Massage Therapist in Redmond, WA
• Providers in Redmond, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.