NPIMap

Organization Active NPI

Greater Peoria Physical Medicine

  • Massage Therapist
  • Peoria, IL
National Provider Identifier
1699152488
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.007402 Issued in IL
Legal business name
GREATER PEORIA PHYSICAL MEDICINE
Practice address
5001 N University St
Peoria, IL 61614-4799
Phone
(309) 693-2225
NPI assigned
Apr 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Mr. Marshall Collier
Title
LMT
Phone
(309) 693-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X 227.007402 IL Primary

Addresses

Primary practice location

5001 N University St
Peoria, IL 61614-4799

Mailing address

5001 N University St
Peoria, IL 61614-4799

National Provider Directory

National Provider Directory
Tax ID family
Greater Peoria Physical Medicine Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5001 N University St
Peoria, IL 61614
Phone (309) 692-2525

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1699152488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144799",
            "telephone_number": "309-693-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER PEORIA PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "LMT",
        "authorized_official_telephone_number": "309-693-2225",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.007402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.