Active NPI
Anthony James Dovolos
- Massage Therapist
- Minneapolis, MN
National Provider Identifier
1700396249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 9522886958
- Practice address
- 2937 Lyndale Ave S Ste B002C
Minneapolis, MN 55408-2171 - Phone
- (612) 879-8000
- Fax
- (612) 879-8000
- NPI assigned
- Oct 11, 2017
- Sex
- Male
- Sole proprietor
- No
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 | 9522886958 | MN | Primary |
Addresses
Primary practice location
2937 Lyndale Ave S Ste B002C
Minneapolis, MN 55408-2171
Mailing address
1357 Idaho Ave S
St Louis Park, MN 55426-2207
Phone (952) 288-6958
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 |
|---|---|---|---|
| 9522886958 | MN | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507680000000",
"number": "1700396249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1357 IDAHO AVE S",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554262207",
"telephone_number": "952-288-6958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2937 LYNDALE AVE S STE B002C",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082171",
"telephone_number": "612-879-8000",
"fax_number": "612-879-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOVOLOS",
"first_name": "ANTHONY",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-11",
"last_updated": "2017-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MN",
"license": "9522886958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.