NPIMap

Organization Active NPI

Wyatt Demarco Massage Therapy & Wellness Center

  • Massage Therapist
  • Avon Lake, OH
National Provider Identifier
1649743352
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
WYATT DEMARCO MASSAGE THERAPY & WELLNESS CENTER
Practice address
690 Avon Belden Rd
2C
Avon Lake, OH 44012
Phone
(440) 225-4555
NPI assigned
Jan 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Authorized official

Name
Jessica R Wyatt, LMTNPI 1033495338
Title
Owner
Phone
(440) 225-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

690 Avon Belden Rd
2C
Avon Lake, OH 44012

Mailing address

690 Avon Belden Rd
2C
Avon Lake, OH 44012
Phone (440) 225-4555

National Provider Directory

National Provider Directory

Locations

690 Avon Belden Rd
Ste 2C
Avon Lake, OH 44012
Phone (440) 225-4555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1649743352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 AVON BELDEN RD",
            "address_2": "2C",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "44012",
            "telephone_number": "440-225-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 AVON BELDEN RD",
            "address_2": "2C",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "44012",
            "telephone_number": "440-225-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT DEMARCO MASSAGE THERAPY & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-225-4555",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.

Verify at the official NPI Registry.