Individual provider Active NPI

Andrenique Bess

  • Massage Therapist
  • Sterling Heights, MI
National Provider Identifier
1811627706
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501014779 Issued in MI
Practice address
34971 Aquarius Dr Apt E210
Sterling Heights, MI 48310-5633
Phone
(313) 221-7657
NPI assigned
Jun 14, 2022
Last updated
Jun 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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 7501014779 MI Primary

Addresses

Primary practice location

34971 Aquarius Dr Apt E210
Sterling Heights, MI 48310-5633

Mailing address

34971 Aquarius Dr Apt E210
Sterling Heights, MI 48310-5633
Phone (313) 221-7657

Other identifiers 1

IdentifierTypeStateIssuer
B200067585644MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Soap

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
7501014779MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1811627706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34971 AQUARIUS DR APT E210",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105633",
            "telephone_number": "313-221-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34971 AQUARIUS DR APT E210",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105633",
            "telephone_number": "313-221-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESS",
        "first_name": "ANDRENIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501014779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B200067585644",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Soap",
            "affiliation": "N",
            "address_1": "34971 Aquarius Dr Apt E210",
            "city": "Sterling Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483105633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.