Active NPI
Richard Allen Enocksen II, MASSAGE THERAPIST
- Massage Therapist
- Greeley, CO
National Provider Identifier
1811596406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT.0022466
- Practice address
- 5551 29TH St Unit 715
Greeley, CO 80634-8326 - Phone
- (970) 381-3456
- NPI assigned
- Oct 23, 2020
- 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 | MT.0022466 | CO | Primary |
Addresses
Primary practice location
5551 29TH St Unit 715
Greeley, CO 80634-8326
Mailing address
5551 29TH St Unit 715
Greeley, CO 80634-8326
Phone (970) 381-3456
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT.0022466 | CO | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rae'S Natural Therapy | Massage Therapist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Massage Therapist
- Woodinville, WA
- NPI 1710744297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603411200000",
"number": "1811596406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5551 29TH ST UNIT 715",
"city": "GREELEY",
"state": "CO",
"postal_code": "806348326",
"telephone_number": "970-381-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5551 29TH ST UNIT 715",
"city": "GREELEY",
"state": "CO",
"postal_code": "806348326",
"telephone_number": "970-381-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENOCKSEN",
"first_name": "RICHARD",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-23",
"last_updated": "2020-10-23",
"certification_date": "2020-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT.0022466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.