Active NPI
Roberta Ann Groth, LMT
- Massage Therapist
- Nampa, ID
National Provider Identifier
1699250084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MASG-1782
- Practice address
- 430 W Iowa Ave Ste a
Nampa, ID 83686-2826 - Phone
- (208) 870-6658
- NPI assigned
- Oct 1, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | MASG-1782 | ID | Primary |
Addresses
Primary practice location
430 W Iowa Ave Ste a
Nampa, ID 83686-2826
Mailing address
430 W Iowa Ave Ste a
Nampa, ID 83686-2826
Phone (208) 870-6658
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MASG-1782 | Other | ID | IDAHO BUREAU OF OCCUPATIONAL LICENSES |
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 |
|---|---|---|---|
| MASG-1782 | ID | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538352000000",
"number": "1699250084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 W IOWA AVE STE A",
"city": "NAMPA",
"state": "ID",
"postal_code": "836862826",
"telephone_number": "208-870-6658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 W IOWA AVE STE A",
"city": "NAMPA",
"state": "ID",
"postal_code": "836862826",
"telephone_number": "208-870-6658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROTH",
"first_name": "ROBERTA",
"middle_name": "ANN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-01",
"last_updated": "2018-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MASG-1782",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO BUREAU OF OCCUPATIONAL LICENSES",
"identifier": "MASG-1782",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.