Tara Surprenant, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAS4938 Issued in ID

Practice address

2151 W Hayden Ave
Hayden, ID 83835-7414

Phone

(208) 762-6772

NPI assigned

Dec 6, 2022

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Balanced Body Massage

  • Massage Therapist
  • Hayden, ID
  • NPI 1821982950
  NPD
• Body Tech Massage & Wellness

  • Primary Care Clinic/Center
  • Hayden, ID
  • NPI 1073120317
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 6, 2022.

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1710698212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357414",
            "telephone_number": "208-762-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357414",
            "telephone_number": "208-762-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURPRENANT",
        "first_name": "TARA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS4938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Michelle Strigotte, LPC
• Anna Strong, RN, CCH
• Terri Lynn Sudol, M.S.W., L.C.S.W.
• Kathryn Suhr, LMT
• Summit Health & Wellness LLC
• Susan Keeley Counseling Services, PC
• Katrina Ann Susca, RN, IBCLC
• Paul Swanson Jr., LMHCA
• Sierra Swick, LCPC.
• Syringa Bodywork LLC

• All providers in Hayden, ID
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.