Individual provider Active NPI

Stephanie Athena-Marie

  • Massage Therapist
  • Durango, CO
National Provider Identifier
1598200412
Registry record updated Jan 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0013180 Issued in CO
Practice address
1140 Main Ave Unit a
Durango, CO 81301-5387
Phone
(303) 483-3815
NPI assigned
Jan 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2017

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 0013180 CO Primary

Addresses

Primary practice location

1140 Main Ave Unit a
Durango, CO 81301-5387

Mailing address

1819 E 2ND Ave
Durango, CO 81301-5018
Phone (303) 483-3815

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
0013180COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1483228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483228800000",
    "number": "1598200412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 E 2ND AVE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015018",
            "telephone_number": "303-483-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 MAIN AVE UNIT A",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015387",
            "telephone_number": "303-483-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHENA-MARIE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-01",
        "last_updated": "2017-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "0013180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

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

Verify at the official NPI Registry.