Bend Sovereign Wellness LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

BEND SOVEREIGN WELLNESS LLC

Practice address

2330 NE Division St Ste 8
Bend, OR 97703-3570

Phone

(541) 728-0932

NPI assigned

Oct 7, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Savanah Imus, LMTNPI 1356982862

Title

Owner

Phone

(541) 326-8890

Specialties & licenses 1

Addresses

Other names 1

• Bend Sovereign Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Savanah J Imus

  • Massage Therapist
  • Bend, OR
  • NPI 1356982862
  NPD Authorized official

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1679392641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 NE DIVISION ST STE 8",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033570",
            "telephone_number": "541-728-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 NE DIVISION ST STE 8",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033570",
            "telephone_number": "541-728-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEND SOVEREIGN WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "IMUS",
        "authorized_official_first_name": "SAVANAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-326-8890",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bend Sovereign Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Massage Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.

Verify at the official NPI Registry.