Advanced Massage and Bodywork, LLC

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

227.007642 Issued in IL

Legal business name

ADVANCED MASSAGE AND BODYWORK, LLC

Practice address

82 E Ferguson Ave
Wood River, IL 62095-1904

Phone

(618) 254-2626

NPI assigned

Jan 14, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kay Eberhart, M.M.P.NPI 1235368093

Title

Owner

Phone

(618) 254-2626

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kay Eberhart, M.M.P.

  • Massage Therapist
  • Wood River, IL
  • NPI 1235368093
  NPD (past) Authorized official

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1730484148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 E FERGUSON AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951904",
            "telephone_number": "618-254-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 E FERGUSON AVE",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951904",
            "telephone_number": "618-254-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MASSAGE AND BODYWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-14",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "EBERHART",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-254-2626",
        "authorized_official_credential": "M.M.P."
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mechanotherapist",
            "state": "IL",
            "license": "227.007642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mechanotherapist in Wood River, IL
• Providers in Wood River, IL by specialty
• Mechanotherapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.