Active NPI
Arieyl Lyn McCormack
- Massage Therapist
- Bend, OR
National Provider Identifier
1588056105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21174
- Practice address
- 3075 NW Kelly Hill CT Apt 2
Bend, OR 97701-7034 - Phone
- (541) 968-6255
- NPI assigned
- Feb 19, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 21174 | OR | Primary |
Addresses
Primary practice location
3075 NW Kelly Hill CT Apt 2
Bend, OR 97701-7034
Mailing address
3075 NW Kelly Hill CT Apt 2
Bend, OR 97701-7034
Phone (541) 968-6255
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 |
|---|---|---|---|
| 21174 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424304000000",
"number": "1588056105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3075 NW KELLY HILL CT APT 2",
"city": "BEND",
"state": "OR",
"postal_code": "977017034",
"telephone_number": "541-968-6255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3075 NW KELLY HILL CT APT 2",
"city": "BEND",
"state": "OR",
"postal_code": "977017034",
"telephone_number": "541-968-6255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMACK",
"first_name": "ARIEYL",
"middle_name": "LYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-19",
"last_updated": "2015-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "21174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.