Active NPI
Stephane Marie Smith, LMT
- Massage Therapist
- Manitowoc, WI
National Provider Identifier
1548776347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12531-146
- Practice address
- 814 Jay St
Manitowoc, WI 54220-4520 - Phone
- (920) 686-0328
- NPI assigned
- Dec 17, 2017
- Sex
- Female
- 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 | 12531-146 | WI | Primary |
Addresses
Primary practice location
814 Jay St
Manitowoc, WI 54220-4520
Mailing address
731 S 15TH St
Manitowoc, WI 54220-3802
Phone (920) 323-6587
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 |
|---|---|---|---|
| 12531-146 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apple Clinic SC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513468800000",
"number": "1548776347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 S 15TH ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542203802",
"telephone_number": "920-323-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 JAY ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204520",
"telephone_number": "920-686-0328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "STEPHANE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-17",
"last_updated": "2017-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "WI",
"license": "12531-146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.