Individual provider Active NPI

Amy Elizabeth Grossman, LMT

  • Massage Therapist
  • Chardon, OH
National Provider Identifier
1710164983
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
33.012057 Issued in OH
Practice address
425 Water St
Slender You Spa
Chardon, OH 44024-1236
Phone
(440) 286-1779
NPI assigned
Jan 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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 33.012057 OH Primary

Addresses

Primary practice location

425 Water St
Slender You Spa
Chardon, OH 44024-1236

Mailing address

108 Park Ave
Chardon, OH 44024-1331
Phone (440) 226-0704

Other names 1

  • Miss Amy Elizabeth Maple Former name

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

LicenseStateTypeSpecialty
33.012057OHMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1710164983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PARK AVE",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241331",
            "telephone_number": "440-226-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 WATER ST",
            "address_2": "SLENDER YOU SPA",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241236",
            "telephone_number": "440-286-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.012057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MAPLE",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.