Active NPI
Bruce Kenyon
- Massage Therapist
- Ojai, CA
National Provider Identifier
1508459033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 85216
- Practice address
- 972 Tico Rd # 972
Ojai, CA 93023-3558 - Phone
- (805) 798-5493
- NPI assigned
- Feb 16, 2021
- Sex
- Male
- 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 | 85216 | CA | Primary |
Addresses
Primary practice location
972 Tico Rd # 972
Ojai, CA 93023-3558
Mailing address
972 Tico Rd
Ojai, CA 93023-3558
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94480096G40269 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | integrativetechniques.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 85216 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613433600000",
"number": "1508459033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "972 TICO RD",
"city": "OJAI",
"state": "CA",
"postal_code": "930233558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "972 TICO RD # 972",
"city": "OJAI",
"state": "CA",
"postal_code": "930233558",
"telephone_number": "805-798-5493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENYON",
"first_name": "BRUCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-16",
"last_updated": "2021-02-16",
"certification_date": "2021-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "CA",
"license": "85216",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "94480096G40269",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "integrativetechniques.com",
"affiliation": "N",
"address_1": "972 Tico Rd # 972",
"city": "Ojai",
"state": "CA",
"country_code": "US",
"postal_code": "930233558",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ojai, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.