Individual provider Active NPI

Amy Willison

  • Massage Therapist
  • Sioux Falls, SD
National Provider Identifier
1649990672
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT11806 Issued in SD
Practice address
100 N Krohn PL
Sioux Falls, SD 57103-1815
Phone
(605) 331-0588
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 MT11806 SD Primary

Addresses

Primary practice location

100 N Krohn PL
Sioux Falls, SD 57103-1815

Mailing address

805 S Honey Locust Ave
Sioux Falls, SD 57110-5308
Phone (605) 251-0736

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
MT11806SDMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1649990672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S HONEY LOCUST AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571105308",
            "telephone_number": "605-251-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N KROHN PL",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571031815",
            "telephone_number": "605-331-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLISON",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SD",
            "license": "MT11806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.