Individual provider Active NPI

Sheryl A Fendall, L.M.T.

  • Massage Therapist
  • Newberg, OR
National Provider Identifier
1790223725
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
#023082 Issued in OR
Practice address
500 Villa Rd
Newberg, OR 97132-1860
Phone
(503) 864-5058
NPI assigned
Feb 9, 2017
Last updated
Apr 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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 #023082 OR Primary

Addresses

Primary practice location

500 Villa Rd
Newberg, OR 97132-1860

Mailing address

401 E 1St St Unit 1072
Newberg, OR 97132-0887
Phone (503) 864-5058

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
#023082ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1790223725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 1ST ST UNIT 1072",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971320887",
            "telephone_number": "503-864-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VILLA RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321860",
            "telephone_number": "503-864-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDALL",
        "first_name": "SHERYL",
        "middle_name": "A",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "#023082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.