Active NPI
Brian Scott Alen Page
- Massage Therapist
- Isanti, MN
National Provider Identifier
1730924713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 4 Enterprise Ave NE Ste 1
Isanti, MN 55040-6814 - Phone
- (763) 552-6161
- NPI assigned
- Jul 1, 2024
- Last updated
- Jul 1, 2024
- 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 | NU | Primary |
Addresses
Primary practice location
4 Enterprise Ave NE Ste 1
Isanti, MN 55040-6814
Mailing address
32904 Flamingo St NW
Cambridge, MN 55008-7672
Phone (763) 288-6750
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willowbridge, Inc. | Massage Therapist | Current | Accepting new patients |
Locations
4 Enterprise Ave NE
Ste 1
Isanti, MN 55040
Phone (763) 552-6161
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1730924713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32904 FLAMINGO ST NW",
"city": "CAMBRIDGE",
"state": "MN",
"postal_code": "550087672",
"telephone_number": "763-288-6750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 ENTERPRISE AVE NE STE 1",
"city": "ISANTI",
"state": "MN",
"postal_code": "550406814",
"telephone_number": "763-552-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "BRIAN",
"middle_name": "SCOTT ALEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-01",
"last_updated": "2024-07-01",
"certification_date": "2024-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Isanti, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.