Individual provider Active NPI

Stephen C Forrester, MASSAGE THERAPIST

  • Contractor
  • Alexandria, LA
National Provider Identifier
1780866160
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
LA#0877 Issued in LA
Practice address
2150 Boyce St
Alexandria, LA 71301-3707
Phone
(318) 441-2211
Fax
(318) 441-1111
NPI assigned
Nov 28, 2007
Last updated
Nov 28, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X LA#0877 LA Primary

Addresses

Primary practice location

2150 Boyce St
Alexandria, LA 71301-3707

Mailing address

2150 Boyce St
Alexandria, LA 71301-3707
Phone (318) 441-2211

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
LA#0877LAMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1780866160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 BOYCE ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013707",
            "telephone_number": "318-441-2211",
            "fax_number": "318-441-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 BOYCE ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013707",
            "telephone_number": "318-441-2211",
            "fax_number": "318-441-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "LA",
            "license": "LA#0877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.