Individual provider Active NPI

Airin Daynah Mitchell, LMT

  • Massage Therapist
  • Medford, OR
National Provider Identifier
1689387268
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
24731 Issued in OR
Practice address
824 E Main St Ste 104
Medford, OR 97504-7135
Phone
(541) 414-3265
NPI assigned
Dec 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 24731 OR Primary

Addresses

Primary practice location

824 E Main St Ste 104
Medford, OR 97504-7135

Mailing address

412 W Jackson St
Medford, OR 97501-2444
Phone (541) 414-3265

Other practice location 1

412 W Jackson St
Medford, OR 97501-2444
Phone (541) 414-3265

Other practice location 2

820 Crater Lake Ave Ste 113
Medford, OR 97504-6581
Phone (541) 770-1606

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
24731ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Wellness NW Massage Therapist PastSince Jan 1, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1689387268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 W JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012444",
            "telephone_number": "541-414-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 E MAIN ST STE 104",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047135",
            "telephone_number": "541-414-3265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975012444",
            "country_code": "US",
            "telephone_number": "541-414-3265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Crater Lake Ave Ste 113",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046581",
            "country_code": "US",
            "telephone_number": "541-770-1606",
            "fax_number": "541-393-9143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AIRIN",
        "middle_name": "DAYNAH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-28",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.