Individual provider Active NPI

Laura Ann Evans, NCTM

  • Massage Therapist
  • Saint Paul, MN
National Provider Identifier
1659623247
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
20120000495 Issued in MN
Practice address
1053 Grand Ave
Suite 109
Saint Paul, MN 55105-3022
Phone
(651) 964-3446
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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 20120000495 MN Primary

Addresses

Primary practice location

1053 Grand Ave
Suite 109
Saint Paul, MN 55105-3022

Mailing address

1053 Grand Ave
Suite 109
Saint Paul, MN 55105-3022
Phone (651) 964-3446

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
20120000495MNMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1659623247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 GRAND AVE",
            "address_2": "SUITE 109",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053022",
            "telephone_number": "651-964-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 GRAND AVE",
            "address_2": "SUITE 109",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053022",
            "telephone_number": "651-964-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NCTM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MN",
            "license": "20120000495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.