Individual provider Active NPI

Amy Moore, LMT

  • Massage Therapist
  • Troy, MI
National Provider Identifier
1649648874
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
476042 Issued in MI
Practice address
1890 Crooks Rd
Suite 140
Troy, MI 48084-5506
Phone
(586) 871-5224
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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 476042 MI Primary

Addresses

Primary practice location

1890 Crooks Rd
Suite 140
Troy, MI 48084-5506

Mailing address

14761 Borgman St
Oak Park, MI 48237-1014
Phone (586) 871-5224

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
476042MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1649648874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14761 BORGMAN ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371014",
            "telephone_number": "586-871-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 CROOKS RD",
            "address_2": "SUITE 140",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845506",
            "telephone_number": "586-871-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMY",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "476042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.