Active NPI
Robert Pridgen, MT
- Massage Therapist
- Denver, CO
National Provider Identifier
1730554783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 0015481
- Practice address
- 1325 S Colorado Blvd
#B16
Denver, CO 80222-3303 - Phone
- (303) 756-9355
- NPI assigned
- Dec 2, 2015
- Sex
- Male
- 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 | 0015481 | NC | Primary |
Addresses
Primary practice location
1325 S Colorado Blvd
#B16
Denver, CO 80222-3303
Mailing address
1325 S Colorado Blvd
#B16
Denver, CO 80222-3303
Phone (706) 248-4542
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
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0015481 | NC | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Randal J Moyer, LLC | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1730554783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 S COLORADO BLVD",
"address_2": "#B16",
"city": "DENVER",
"state": "CO",
"postal_code": "802223303",
"telephone_number": "706-248-4542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 S COLORADO BLVD",
"address_2": "#B16",
"city": "DENVER",
"state": "CO",
"postal_code": "802223303",
"telephone_number": "303-756-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIDGEN",
"first_name": "ROBERT",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-02",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "0015481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.