NPIMap

Organization Active NPI

Epic Wellness NW

  • Massage Therapist
  • Medford, OR
National Provider Identifier
1740661636
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
20099 Issued in OR
Legal business name
EPIC WELLNESS NW
Practice address
820 Crater Lake Ave
Suite 113
Medford, OR 97504-6581
Phone
(541) 770-1606
NPI assigned
Jun 16, 2015
Last updated
Mar 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Authorized official

Name
Callie Knight
Title
Owner/Manager
Phone
(541) 770-1606

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Massage Therapist 225700000X 20067 OR
Massage Therapist 225700000X 20099 OR Primary

Addresses

Primary practice location

820 Crater Lake Ave
Suite 113
Medford, OR 97504-6581

Mailing address

820 Crater Lake Ave
Suite 113
Medford, OR 97504-6581
Phone (541) 770-1606

National Provider Directory

National Provider Directory

Locations

820 Crater Lake Ave
Ste 113
Medford, OR 97504
Phone (541) 770-1606

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1740661636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 CRATER LAKE AVE",
            "address_2": "SUITE 113",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046581",
            "telephone_number": "541-770-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 CRATER LAKE AVE",
            "address_2": "SUITE 113",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046581",
            "telephone_number": "541-770-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC WELLNESS NW",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "CALLIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "541-770-1606"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "20067",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "20099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.