Active NPI
Deborah St. John
- Massage Therapist
- Escanaba, MI
National Provider Identifier
1720409451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- C20010018
- Practice address
- 902 Ludington St
Escanaba, MI 49829-3827 - Phone
- (906) 399-9000
- NPI assigned
- Dec 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | C20010018 | MI | Primary |
Addresses
Primary practice location
902 Ludington St
Escanaba, MI 49829-3827
Mailing address
5011 Maple 16.45 Dr
Escanaba, MI 49829-9414
Phone (906) 399-7827
Other names 1
- Deborah Wagner
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 |
|---|---|---|---|
| C20010018 | MI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387843200000",
"number": "1720409451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5011 MAPLE 16.45 DR",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498299414",
"telephone_number": "906-399-7827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 LUDINGTON ST",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498293827",
"telephone_number": "906-399-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST. JOHN",
"first_name": "DEBORAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-24",
"last_updated": "2013-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MI",
"license": "C20010018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DEBORAH",
"last_name": "WAGNER",
"credential": "CMT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Escanaba, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.