Active NPI
Diane M. Burgess, CMMP, LMT
- Massage Therapist
- Irving, TX
National Provider Identifier
1760601470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT014585
- Practice address
- 1214 W Pioneer Dr
Irving, TX 75061-7308 - Phone
- (214) 507-1738
- Fax
- (972) 790-5099
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- 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 | MT014585 | TX | Primary |
Addresses
Primary practice location
1214 W Pioneer Dr
Irving, TX 75061-7308
Mailing address
2226 Druid Dr
Irving, TX 75060-5011
Phone (214) 507-1738
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 |
|---|---|---|---|
| MT014585 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760601470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2226 DRUID DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750605011",
"telephone_number": "214-507-1738",
"fax_number": "972-790-5099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1214 W PIONEER DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750617308",
"telephone_number": "214-507-1738",
"fax_number": "972-790-5099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "DIANE",
"middle_name": "M.",
"credential": "CMMP, LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT014585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
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.