Massage for Athletes, Inc.

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

MASSAGE FOR ATHLETES, INC.

Practice address

418 Aviation Blvd Ste D
Santa Rosa, CA 95403-1074

Phone

(707) 541-6258

Fax

(707) 284-0122

NPI assigned

May 18, 2021

Organization subpart

No

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

Authorized official

Name

Coralie JennerNPI 1962944157

Title

Owner/Ceo

Phone

(707) 541-6258

Specialties & licenses 5

Addresses

Other names 1

• Massage For Atheltes Sports & Medical Massage Other name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Coralie Jenner, CMT, LMT, HHP

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1962944157

  Health Educator

  NPD Authorized official
• Angela Perez, LMT, CMT

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1093385916

  Health Educator

  NPD

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1750955381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 AVIATION BLVD STE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031074",
            "telephone_number": "707-541-6258",
            "fax_number": "707-284-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 AVIATION BLVD STE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031074",
            "telephone_number": "707-541-6258",
            "fax_number": "707-284-0122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 Aviation Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031032",
            "country_code": "US",
            "telephone_number": "707-541-6258",
            "fax_number": "707-284-0122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MASSAGE FOR ATHLETES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "JENNER",
        "authorized_official_first_name": "CORALIE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "707-541-6258"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Massage For Atheltes Sports & Medical Massage",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Massage For Atheltes Sports & Medical Massage",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Acacia Mason, DC
• Antoinette Jenna Mason, MD
• Hailey Jean Mason
• William Henry Mason, DPM
• Eloisa Ruano Masror, MA, AMFT
• Henri Raymond Masse, GNP
• Kevin Massey, N.P.
• Heather Lea Massie, PT
• Monty Massie
• Stacey N. Massignan, M.D.

• Massage Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.