Individual provider Active NPI

Nicole Josette Ryckenbusch, LMT

  • Massage Therapist
  • Cottage Grove, OR
National Provider Identifier
1528126950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2570 Issued in OR
Practice address
502 Whiteakes
Cottage Grove, OR 97424
Phone
(541) 542-9469
NPI assigned
Dec 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2570 OR Primary

Addresses

Primary practice location

502 Whiteakes
Cottage Grove, OR 97424

Mailing address

502 Whiteakes
Center for Massage Therapy
Cottage Grove, OR 97424
Phone (541) 542-9469

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
2570ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528126950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 WHITEAKES",
            "address_2": "CENTER FOR MASSAGE THERAPY",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "97424",
            "telephone_number": "541-542-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 WHITEAKES",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "97424",
            "telephone_number": "541-542-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYCKENBUSCH",
        "first_name": "NICOLE",
        "middle_name": "JOSETTE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "2570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.