Individual provider Active NPI

Aisha Gaut, LMT

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1669700332
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
16653 Issued in OR
Practice address
384 SW Upper Terrace Dr Ste 104
Bend, OR 97702-1887
Phone
(541) 419-4823
NPI assigned
Nov 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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 16653 OR Primary

Addresses

Primary practice location

384 SW Upper Terrace Dr Ste 104
Bend, OR 97702-1887

Mailing address

384 SW Upper Terrace Dr Ste 104
Bend, OR 97702-1887
Phone (541) 419-4823

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
16653ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1669700332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 SW UPPER TERRACE DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021887",
            "telephone_number": "541-419-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 SW UPPER TERRACE DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021887",
            "telephone_number": "541-419-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUT",
        "first_name": "AISHA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "16653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.