Active NPI
Bladimir Marte, MASSAGE THERAPY
- Massage Therapist
- Provo, UT
National Provider Identifier
1740912369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 11343515-4701
- Practice address
- 1849 N 1120 W
Provo, UT 84604-1180 - Phone
- (801) 960-8789
- NPI assigned
- Jun 30, 2022
- 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 | 11343515-4701 | UT | Primary |
Addresses
Primary practice location
1849 N 1120 W
Provo, UT 84604-1180
Mailing address
124 W 1435 S
Orem, UT 84058-7467
Phone (908) 838-2092
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11343515-4701 | UT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1740912369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 W 1435 S",
"city": "OREM",
"state": "UT",
"postal_code": "840587467",
"telephone_number": "908-838-2092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1849 N 1120 W",
"city": "PROVO",
"state": "UT",
"postal_code": "846041180",
"telephone_number": "801-960-8789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTE",
"first_name": "BLADIMIR",
"credential": "MASSAGE THERAPY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-30",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "UT",
"license": "11343515-4701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.