Michelle Lynette Goymerac, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

664 Issued in CO

Practice address

507 Silver Lakes Dr
Dumont, CO 80436-5090

Phone

(970) 290-3545

NPI assigned

Jan 22, 2008

Last updated

Feb 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Michelle Reid Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Aspen Medical Massage LLC

  • Specialist
  • Golden, CO
  • NPI 1407107360
  NPD (past) Authorized official

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1649457649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 391",
            "city": "DUMONT",
            "state": "CO",
            "postal_code": "804360391",
            "telephone_number": "970-290-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 SILVER LAKES DR",
            "city": "DUMONT",
            "state": "CO",
            "postal_code": "804365090",
            "telephone_number": "970-290-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOYMERAC",
        "first_name": "MICHELLE",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "664",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPY",
            "identifier": "352309556",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "REID",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• County of Clear Creek (Clear Creek County EMS)
• Julie Hagen, PHARMD
• Tyler Marcus Holmes, PARAMEDIC
• John Aldous Manasjan, NREMT-P, FP-C
• Ariel Wertenberger

• Specialist in Dumont, CO
• Providers in Dumont, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.