Active NPI
Keith Oscar Manich, LICENSED MASSAGE THE
- Massage Therapist
- Medford, OR
National Provider Identifier
1639383086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12489OREGON
- Practice address
- 2596 E Barnett Rd
Rogue Health LLC
Medford, OR 97504-4340 - Phone
- (541) 261-2222
- NPI assigned
- May 9, 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 | 12489OREGON | OR | Primary |
Addresses
Primary practice location
2596 E Barnett Rd
Rogue Health LLC
Medford, OR 97504-4340
Mailing address
630 E 9TH St
Medford, OR 97504-7321
Phone (541) 261-2222
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 |
|---|---|---|---|
| 12489OREGON | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1639383086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 E 9TH ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047321",
"telephone_number": "541-261-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2596 E BARNETT RD",
"address_2": "ROGUE HEALTH LLC",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044340",
"telephone_number": "541-261-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANICH",
"first_name": "KEITH",
"middle_name": "OSCAR",
"name_prefix": "Mr.",
"credential": "LICENSED MASSAGE THE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "12489OREGON",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.