NPIMap

Organization Active NPI

Medisage, LLC

  • Massage Therapist
  • Tempe, AZ
National Provider Identifier
1760811400
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-18159 Issued in AZ
Legal business name
MEDISAGE, LLC
Practice address
5016 S Ash Ave
Suite 105
Tempe, AZ 85282-6845
Phone
(623) 295-9001
NPI assigned
Nov 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Mr. John M Bonk, LMT
Title
Owner/Operator
Phone
(623) 295-9001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MT-18159 AZ Primary

Addresses

Primary practice location

5016 S Ash Ave
Suite 105
Tempe, AZ 85282-6845

Mailing address

2602 N 87TH Ter
Scottsdale, AZ 85257-1844
Phone (623) 295-9001

National Provider Directory

National Provider Directory

Locations

5016 S Ash Ave
Ste 105
Tempe, AZ 85282
Phone (623) 295-9001

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1760811400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 N 87TH TER",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852571844",
            "telephone_number": "623-295-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 S ASH AVE",
            "address_2": "SUITE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826845",
            "telephone_number": "623-295-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "BONK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "623-295-9001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-18159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.