Individual provider Active NPI

Brenda Peters, L.M.T.

  • Massage Therapist
  • Plymouth, MI
National Provider Identifier
1720455637
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501000458 Issued in MI
Practice address
40540 E Ann Arbor TRL
Plymouth, MI 48170-4402
Phone
(734) 956-0012
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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 7501000458 MI Primary

Addresses

Primary practice location

40540 E Ann Arbor TRL
Plymouth, MI 48170-4402

Mailing address

40540 E Ann Arbor TRL
Plymouth, MI 48170-4402
Phone (734) 956-0012

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
7501000458MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1720455637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40540 E ANN ARBOR TRL",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704402",
            "telephone_number": "734-956-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40540 E ANN ARBOR TRL",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704402",
            "telephone_number": "734-956-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BRENDA",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501000458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.