Individual provider Active NPI

Susan Connor McLoughlin

  • Massage Therapist
  • Santa Rosa, CA
National Provider Identifier
1700510021
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18375 Issued in CA
Practice address
653 Charles St
Santa Rosa, CA 95404-5020
Phone
(707) 695-7518
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 18375 CA Primary

Addresses

Primary practice location

653 Charles St
Santa Rosa, CA 95404-5020

Mailing address

653 Charles St
Santa Rosa, CA 95404-5020
Phone (707) 695-7518

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

NPI Registry JSON

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1700510021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 CHARLES ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045020",
            "telephone_number": "707-695-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 CHARLES ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045020",
            "telephone_number": "707-695-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLOUGHLIN",
        "first_name": "SUSAN",
        "middle_name": "CONNOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "18375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.