Tammy Ann Nicodemus, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11824 Issued in OR

Practice address

38916 Proctor Blvd
Sandy, OR 97055

Phone

(503) 668-3530

NPI assigned

Jan 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Eric S Lemay RN DC PC

  dba Bull Run Chiropractic Clinic

  • Health Service Clinic/Center
  • Sandy, OR
  • NPI 1053586081
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760539092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202",
            "city": "EAGLE CREEK",
            "state": "OR",
            "postal_code": "970220202",
            "telephone_number": "503-709-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38916 PROCTOR BLVD",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "97055",
            "telephone_number": "503-668-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODEMUS",
        "first_name": "TAMMY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "11824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy P. Monnie, PC (Sandy Physical Therapy)
• Amanda Nash, RD, LD
• Aubrey Nelson
• Megan E Nichols, PA-C
• Stephen Frank Nicholson, MD
• Jeremy Daniel Noel, CRNA
• Ellen M O'Toole, M.ED, LPC
• Lindsay Olsen, FNP
• Madison E Omohundro, BS
• Orchid Oakridge Clinic, PC (Orchid Health Hoodland Clinic)

• Massage Therapist in Sandy, OR
• Providers in Sandy, OR by specialty
• Massage Therapist in Oregon

• 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.