Active NPI
Tanya R Stout, LMT
- Massage Therapist
- Missoula, MT
National Provider Identifier
1730685975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- LMT-LIC-2019
- Practice address
- 825 W Kent Ave
Missoula, MT 59801-6619 - Phone
- (406) 544-6679
- NPI assigned
- Apr 5, 2018
- 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 | LMT-LIC-2019 | Primary |
Addresses
Primary practice location
825 W Kent Ave
Missoula, MT 59801-6619
Mailing address
825 W Kent Ave
Missoula, MT 59801-6619
Phone (406) 544-6679
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LMT-LIC-2019 | Other | MT | MASSAGE LICENSE |
| LMT-LIC-2019 | Other | MT | MONTANA BOARD OF MASSAGE THERAPY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1730685975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 W KENT AVE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598016619",
"telephone_number": "406-544-6679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 W KENT AVE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598016619",
"telephone_number": "406-544-6679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "TANYA",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": "LMT-LIC-2019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE LICENSE",
"identifier": "LMT-LIC-2019",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MONTANA BOARD OF MASSAGE THERAPY",
"identifier": "LMT-LIC-2019",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.