Individual provider Active NPI

Autumn Gonzalez-Belcher, LMT

  • Massage Therapist
  • Princeton, WV
National Provider Identifier
1710356480
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2015-3335 Issued in WV
Practice address
222 New Hope Rd
Princeton, WV 24740-2135
Phone
(304) 910-9880
NPI assigned
Sep 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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 2015-3335 WV Primary

Addresses

Primary practice location

222 New Hope Rd
Princeton, WV 24740-2135

Mailing address

213 Dusty Miller St
Princeton, WV 24740-7666
Phone (304) 910-9880

Other practice location 1

313 Locust St
Princeton, WV 24740-3625
Phone (304) 425-7709

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
2015-3335WVMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1710356480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 DUSTY MILLER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247407666",
            "telephone_number": "304-910-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 NEW HOPE RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402135",
            "telephone_number": "304-910-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "313 Locust St",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "WV",
            "postal_code": "247403625",
            "country_code": "US",
            "telephone_number": "304-425-7709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ-BELCHER",
        "first_name": "AUTUMN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "2015-3335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.