Brookeside LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

BROOKESIDE LLC

Practice address

80 Acoma Blvd S Ste 104&106
Lake Havasu City, AZ 86403-6925

Phone

(928) 453-1055

NPI assigned

Dec 4, 2023

Last updated

Dec 4, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brooke Nichole Foltz, LMTNPI 1326770363

Title

Owner/Massage Therapist

Phone

(971) 273-9432

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brooke Foltz, LMP

  • Massage Therapist
  • Lake Havasu City, AZ
  • NPI 1326770363

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1528834207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 SARATOGA AVE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864066956",
            "telephone_number": "971-273-9432",
            "fax_number": "928-224-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ACOMA BLVD S STE 104&106",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036925",
            "telephone_number": "928-453-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKESIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "FOLTZ",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "971-273-9432",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326770363",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridge Medical Services LLC (sunrise pharmacy)
• Elizabeth A Briere, P.T.
• Brighter Beginnings Therapy
• Stephanie R Brison, APRN
• Sandra Marie Bronni, M.D.
• Pamela Robin Brookman
• Jackson Thomas Lee Buckman, OD
• Buena Suerte, Inc. (Comfort Keepers #697)
• Ryan Newell Bullen, DMD, DHSC
• Rhett Melvin Burgener, OD

• Massage Therapist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Massage Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.