Individual provider Active NPI

Heavenly Martinez, RMT

  • Massage Therapist
  • Greeley, CO
National Provider Identifier
1831624329
Registry record updated Apr 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT.0012230 Issued in CO
Practice address
4617 W 20TH St Ste 2a
Greeley, CO 80634-3207
Phone
(970) 352-9022
Fax
(970) 352-9048
NPI assigned
Apr 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 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 MT.0012230 CO Primary

Addresses

Primary practice location

4617 W 20TH St Ste 2a
Greeley, CO 80634-3207

Mailing address

4617 W 20TH St Ste 2a
Greeley, CO 80634-3207
Phone (970) 352-9022

Other names 1

  • Heavenly Ricks Former name

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
MT.0012230COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc Past Accepting new patients
Alliance Physical Therapy, P.C. PastSince Dec 15, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1492819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492819200000",
    "number": "1831624329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 W 20TH ST STE 2A",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343207",
            "telephone_number": "970-352-9022",
            "fax_number": "970-352-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 W 20TH ST STE 2A",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343207",
            "telephone_number": "970-352-9022",
            "fax_number": "970-352-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "HEAVENLY",
        "credential": "RMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-22",
        "last_updated": "2017-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0012230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEAVENLY",
            "last_name": "RICKS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 22, 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.