Individual provider Active NPI

Monique Nicole Ybarra, LMT

  • Massage Therapist
  • Grants Pass, OR
National Provider Identifier
1629318175
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
19407 Issued in OR
Practice address
1550 Nebraska Ave
Grants Pass, OR 97527-5531
Phone
(541) 479-3100
NPI assigned
Feb 20, 2013
Last updated
Feb 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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 19407 OR Primary

Addresses

Primary practice location

1550 Nebraska Ave
Grants Pass, OR 97527-5531

Mailing address

1550 Nebraska Ave
Grants Pass, OR 97527-5531
Phone (541) 479-3100

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
19407ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Young Men's Christian Association of Grants Pass, Oregon PastSince Oct 11, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1629318175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275531",
            "telephone_number": "541-479-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275531",
            "telephone_number": "541-479-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YBARRA",
        "first_name": "MONIQUE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.