Active NPI
Brandon Joe Rutten
- Massage Therapist
- Indianapolis, IN
National Provider Identifier
1780170357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 609 E 29TH St RM 105
Indianapolis, IN 46205-4160 - Phone
- (367) 013-5923
- NPI assigned
- Jul 7, 2018
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
609 E 29TH St RM 105
Indianapolis, IN 46205-4160
Mailing address
609 E 29TH St RM 105
Indianapolis, IN 46205-4160
Phone (367) 013-5923
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530921600000",
"number": "1780170357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 E 29TH ST RM 105",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462054160",
"telephone_number": "367-013-5923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 E 29TH ST RM 105",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462054160",
"telephone_number": "367-013-5923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTTEN",
"first_name": "BRANDON",
"middle_name": "JOE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-07",
"last_updated": "2018-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.