Active NPI
Amy Leigh Forkan
- Massage Therapist
- McCall, ID
National Provider Identifier
1669923892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS-1958
- Practice address
- 301 E Park St.
McCall, ID 83638 - Phone
- (208) 630-3764
- NPI assigned
- Oct 24, 2016
- Sex
- Female
- Sole proprietor
- No
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 | MAS-1958 | ID | Primary |
Addresses
Primary practice location
301 E Park St.
McCall, ID 83638
Mailing address
PO Box 975
Donnelly, ID 83615-0975
Phone (208) 630-3764
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 |
|---|---|---|---|
| MAS-1958 | ID | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477267200000",
"number": "1669923892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 975",
"city": "DONNELLY",
"state": "ID",
"postal_code": "836150975",
"telephone_number": "208-630-3764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E PARK ST.",
"city": "MCCALL",
"state": "ID",
"postal_code": "83638",
"telephone_number": "208-630-3764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORKAN",
"first_name": "AMY",
"middle_name": "LEIGH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-24",
"last_updated": "2016-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MAS-1958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McCall, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.