Individual provider Active NPI

Deloris Carolyn Brice

  • Massage Therapist
  • Fairbanks, AK
National Provider Identifier
1558043364
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
212207 Issued in AK
Practice address
1741 College Rd
Fairbanks, AK 99709-4176
Phone
(907) 456-4521
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 212207 AK Primary

Addresses

Primary practice location

1741 College Rd
Fairbanks, AK 99709-4176

Mailing address

660 Wilcox Ave Apt 15
Fairbanks, AK 99709-3649
Phone (907) 371-7128

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
212207AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Acupuncture Bodywork and Herbs Inc PastSince Aug 6, 2023 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": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1558043364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WILCOX AVE APT 15",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093649",
            "telephone_number": "907-371-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 COLLEGE RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094176",
            "telephone_number": "907-456-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICE",
        "first_name": "DELORIS",
        "middle_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "212207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.