Organization Active NPI

Miraculous Massage Therapist LLC

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1801529151
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MIRACULOUS MASSAGE THERAPIST LLC
Practice address
5803 W Craig Rd Ste 101
Las Vegas, NV 89130-2537
Phone
(702) 290-7689
NPI assigned
Jul 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Yvette Renee ChappelNPI 1245700376
Title
Medical Massage Therapist
Phone
(702) 290-7689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

5803 W Craig Rd Ste 101
Las Vegas, NV 89130-2537

Mailing address

1924 Ashburn Dr
North Las Vegas, NV 89032-0826
Phone (702) 290-7689

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL miraculouslv@gmail.com Direct

National Provider Directory

National Provider Directory

Locations

5803 W Craig Rd
Ste 101
Las Vegas, NV 89130
Phone (702) 290-7689

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1801529151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ASHBURN DR",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320826",
            "telephone_number": "702-290-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 W CRAIG RD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302537",
            "telephone_number": "702-290-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACULOUS MASSAGE THERAPIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "CHAPPEL",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "MEDICAL MASSAGE THERAPIST",
        "authorized_official_telephone_number": "702-290-7689"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "miraculouslv@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "phone number",
            "address_1": "5803 W Craig Rd Ste 101",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891302537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.