Individual provider Active NPI

Angelina Thelin, L.M.T.

  • Massage Therapist
  • Pocatello, ID
National Provider Identifier
1760869291
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MASG-93 Issued in ID
Practice address
920 Dion Drive
Pocatello, ID 83201-3069
Phone
(208) 740-1449
NPI assigned
May 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2015

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 MASG-93 ID Primary

Addresses

Primary practice location

920 Dion Drive
Pocatello, ID 83201-3069

Mailing address

2218 W 800 S
Sterling, ID 83210-1527
Phone (208) 740-1449

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
MASG-93IDMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1760869291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 W 800 S",
            "city": "STERLING",
            "state": "ID",
            "postal_code": "832101527",
            "telephone_number": "208-740-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DION DRIVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013069",
            "telephone_number": "208-740-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELIN",
        "first_name": "ANGELINA",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MASG-93",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.