Individual provider Active NPI

Kevin Phillip Cude

  • Massage Therapist
  • Saint Peters, MO
National Provider Identifier
1801403167
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2017038699 Issued in MO
Practice address
35 Oxbow Rd
Saint Peters, MO 63376-1556
Phone
(314) 288-6934
NPI assigned
Sep 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 2017038699 MO Primary

Addresses

Primary practice location

35 Oxbow Rd
Saint Peters, MO 63376-1556

Mailing address

35 Oxbow Rd
Saint Peters, MO 63376-1556
Phone (314) 288-6934

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
2017038699MOMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1801403167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 OXBOW RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761556",
            "telephone_number": "314-288-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 OXBOW RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761556",
            "telephone_number": "314-288-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDE",
        "first_name": "KEVIN",
        "middle_name": "PHILLIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MO",
            "license": "2017038699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.