Individual provider Active NPI

Holly Pearson, L.M.T., CD-L

  • Massage Therapist
  • Carlton, OR
National Provider Identifier
1568735348
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
455 W Main St
Carlton, OR 97111-8904
Phone
(541) 921-3654
NPI assigned
Feb 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Reflexologist 173C00000X 8316 OR
Doula 374J00000X
Massage Therapist 225700000X Primary

Addresses

Primary practice location

455 W Main St
Carlton, OR 97111-8904

Mailing address

51100 SW Hebo Rd
Grand Ronde, OR 97347-9507

Other practice location 1

1316 NE Highway 99W
McMinnville, OR 97128-2723
Phone (503) 434-6603

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
8316ORMDReflexologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carlton Wellness Studio LLC Massage Therapist CurrentSince May 16, 2021 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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1568735348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51100 SW HEBO RD",
            "city": "GRAND RONDE",
            "state": "OR",
            "postal_code": "973479507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W MAIN ST",
            "city": "CARLTON",
            "state": "OR",
            "postal_code": "971118904",
            "telephone_number": "541-921-3654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1316 NE Highway 99W",
            "address_purpose": "LOCATION",
            "city": "McMinnville",
            "state": "OR",
            "postal_code": "971282723",
            "country_code": "US",
            "telephone_number": "503-434-6603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "HOLLY",
        "credential": "L.M.T., CD-L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "OR",
            "license": "8316",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.

Verify at the official NPI Registry.