Active NPI
Brian Green Green
- Massage Therapist
- Colorado Springs, CO
National Provider Identifier
1669202339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT.0025030
- Practice address
- 2620 Tenderfoot Hill St Ste 10
Colorado Springs, CO 80906-8354 - Phone
- (719) 527-6747
- NPI assigned
- Aug 6, 2024
- Last updated
- Aug 6, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT.0025030 | CO | Primary |
Addresses
Primary practice location
2620 Tenderfoot Hill St Ste 10
Colorado Springs, CO 80906-8354
Mailing address
180 Sun Valley Dr
Woodland Park, CO 80863-9075
Phone (832) 909-6859
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT.0025030 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722902400000",
"number": "1669202339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 SUN VALLEY DR",
"city": "WOODLAND PARK",
"state": "CO",
"postal_code": "808639075",
"telephone_number": "832-909-6859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 TENDERFOOT HILL ST STE 10",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809068354",
"telephone_number": "719-527-6747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "BRIAN",
"middle_name": "GREEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-06",
"last_updated": "2024-08-06",
"certification_date": "2024-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT.0025030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.