Individual provider Active NPI

Paul Kucharyson

  • Massage Therapist
  • Loveland, CO
National Provider Identifier
1629839667
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0004932 Issued in CO
Practice address
2923 Lake Verna Dr
Loveland, CO 80538-7193
Phone
(720) 237-5756
NPI assigned
Jan 17, 2024
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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 0004932 CO Primary

Addresses

Primary practice location

2923 Lake Verna Dr
Loveland, CO 80538-7193

Mailing address

2923 Lake Verna Dr
Loveland, CO 80538-7193
Phone (720) 237-5756

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
0004932COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1629839667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 LAKE VERNA DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805387193",
            "telephone_number": "720-237-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2923 LAKE VERNA DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805387193",
            "telephone_number": "720-237-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHARYSON",
        "first_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "0004932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.