Active NPI
Mark E Harris, LIC MASSAGE THERAPIS
- Massage Therapist
- La Crosse, WI
National Provider Identifier
1619168531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2914 046
- Practice address
- 2400 Diagonal Rd
La Crosse, WI 54601-7619 - Phone
- (608) 784-4471
- NPI assigned
- Aug 6, 2007
- Sex
- Male
- 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 | 2914 046 | WI | Primary |
Addresses
Primary practice location
2400 Diagonal Rd
La Crosse, WI 54601-7619
Mailing address
1314 Johnson St
La Crosse, WI 54601-5616
Phone (608) 784-4471
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 |
|---|---|---|---|
| 2914 046 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CMB Rehabilitation, Inc. | 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.
-
- Home Health Agency
- La Crosse, WI
- NPI 1336184738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1619168531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1314 JOHNSON ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015616",
"telephone_number": "608-784-4471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 DIAGONAL RD",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546017619",
"telephone_number": "608-784-4471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "MARK",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "LIC MASSAGE THERAPIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "2914 046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.