Individual provider Active NPI

Angelica Grieme

  • Massage Therapist
  • Storm Lake, IA
National Provider Identifier
1750415675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
03510 Issued in IA
Practice address
620 Michigan St
Colonial Arcade, Suite#6
Storm Lake, IA 50588-1800
Phone
(712) 732-4322
Fax
(712) 732-4322
NPI assigned
Mar 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 03510 IA Primary

Addresses

Primary practice location

620 Michigan St
Colonial Arcade, Suite#6
Storm Lake, IA 50588-1800

Mailing address

210 Peterson St
Alta, IA 51002-1350
Phone (712) 299-1281

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

LicenseStateTypeSpecialty
03510IAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750415675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 PETERSON ST",
            "city": "ALTA",
            "state": "IA",
            "postal_code": "510021350",
            "telephone_number": "712-299-1281",
            "fax_number": "712-200-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MICHIGAN ST",
            "address_2": "COLONIAL ARCADE, SUITE#6",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881800",
            "telephone_number": "712-732-4322",
            "fax_number": "712-732-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIEME",
        "first_name": "ANGELICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IA",
            "license": "03510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Storm Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.