Individual provider Active NPI

Marisa Durocher, LMT

  • Massage Therapist
  • Redford, MI
National Provider Identifier
1831750710
Registry record updated Jun 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501010888 Issued in MI
Practice address
12727 Mercedes
Redford, MI 48239-3004
Phone
(734) 905-3335
NPI assigned
Jun 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2019

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 7501010888 MI Primary

Addresses

Primary practice location

12727 Mercedes
Redford, MI 48239-3004

Mailing address

12727 Mercedes
Redford, MI 48239-3004
Phone (734) 905-3335

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
7501010888MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1831750710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12727 MERCEDES",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393004",
            "telephone_number": "734-905-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12727 MERCEDES",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393004",
            "telephone_number": "734-905-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROCHER",
        "first_name": "MARISA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501010888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2019; 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.