Individual provider Active NPI

Marjorie Medina-Cook

  • Massage Therapist
  • Red Bluff, CA
National Provider Identifier
1629458328
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
14856 Issued in CA
Practice address
731 Main St Ste 112
Red Bluff, CA 96080-3358
Phone
(619) 957-1298
NPI assigned
Jun 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reflexologist 173C00000X 14856 CA
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 14856 CA Primary

Addresses

Primary practice location

731 Main St Ste 112
Red Bluff, CA 96080-3358

Mailing address

731 Main St Ste 112
Red Bluff, CA 96080-3358
Phone (619) 957-1298

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

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1629458328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 MAIN ST STE 112",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803358",
            "telephone_number": "619-957-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 MAIN ST STE 112",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803358",
            "telephone_number": "619-957-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA-COOK",
        "first_name": "MARJORIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "CA",
            "license": "14856",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "14856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.