Active NPI
Mallory Puthoff, LMT
- Massage Therapist
- Sidney, OH
National Provider Identifier
1619787579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 33.020483
- Practice address
- 915 Michigan St
Sidney, OH 45365-2401 - Phone
- (937) 498-2311
- NPI assigned
- Jan 11, 2025
- 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 | 33.020483 | OH | Primary |
Addresses
Primary practice location
915 Michigan St
Sidney, OH 45365-2401
Mailing address
11594 Conover Rd
Versailles, OH 45380-8423
Phone (937) 564-7424
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 |
|---|---|---|---|
| 33.020483 | OH | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1619787579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11594 CONOVER RD",
"city": "VERSAILLES",
"state": "OH",
"postal_code": "453808423",
"telephone_number": "937-564-7424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 MICHIGAN ST",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453652401",
"telephone_number": "937-498-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTHOFF",
"first_name": "MALLORY",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-11",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OH",
"license": "33.020483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sidney, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.