Active NPI
Mistyanne Green
- Massage Therapist
- Fort Worth, TX
National Provider Identifier
1699389361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT133835
- Practice address
- 1606 N Sylvania Ave
Fort Worth, TX 76111-2733 - Phone
- (972) 567-0718
- NPI assigned
- Sep 1, 2020
- 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 | MT133835 | TX | Primary |
Addresses
Primary practice location
1606 N Sylvania Ave
Fort Worth, TX 76111-2733
Mailing address
232 Cooper Dr
Hurst, TX 76053-6129
Phone (972) 567-0718
Other names 1
- Misty Green
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 |
|---|---|---|---|
| MT133835 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1699389361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 COOPER DR",
"city": "HURST",
"state": "TX",
"postal_code": "760536129",
"telephone_number": "972-567-0718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 N SYLVANIA AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761112733",
"telephone_number": "972-567-0718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MISTYANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-01",
"last_updated": "2020-09-01",
"certification_date": "2020-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT133835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MISTY",
"last_name": "GREEN",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.