Active NPI
Trevor Nathaniel Eller, LMT
- Massage Therapist
- Ann Arbor, MI
National Provider Identifier
1639738164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 75010000149
- Practice address
- 2020 Hogback Rd Ste 8
Ann Arbor, MI 48105-9752 - Phone
- (734) 249-8998
- NPI assigned
- Jun 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 75010000149 | MI | Primary |
Addresses
Primary practice location
2020 Hogback Rd Ste 8
Ann Arbor, MI 48105-9752
Mailing address
304 E Forest Ave
Ypsilanti, MI 48198-3018
Phone (734) 332-8880
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 |
|---|---|---|---|
| 75010000149 | MI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560038400000",
"number": "1639738164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 E FOREST AVE",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481983018",
"telephone_number": "734-332-8880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 HOGBACK RD STE 8",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059752",
"telephone_number": "734-249-8998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLER",
"first_name": "TREVOR",
"middle_name": "NATHANIEL",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-09",
"last_updated": "2019-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MI",
"license": "75010000149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.