Stacey Richelle Cannon, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

664 Issued in MT

Practice address

32 Market Place
Big Sky, MT 59716

Phone

(406) 995-7575

NPI assigned

Aug 31, 2017

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2017.

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1700304565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 S 26TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187434",
            "telephone_number": "406-570-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 MARKET PLACE",
            "city": "BIG SKY",
            "state": "MT",
            "postal_code": "59716",
            "telephone_number": "406-995-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "STACEY",
        "middle_name": "RICHELLE",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MT",
            "license": "664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison M Brown, DPT
• Lisa Brubaker, LCSW
• Ryan Burfeind, PHARM.D.
• Kaley Burns, N.D.
• Brian Matthew Campoli, PT
• Anna Rowena Carl, MD
• Eileen Coil, OTR/L, MOT
• Joshua Daniel, D.P.T.
• Jeffrey A Daniels, MD
• Jessica Elizabeth Dirienzo

• All providers in Big Sky, MT
• Massage Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.