Active NPI
Stefan D'Auteuil
- Massage Therapist
- Sunriver, OR
National Provider Identifier
1841919503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 26867
- Practice address
- 57031 Ponderosa Road
BLD 27 Ste M2
Sunriver, OR 97707 - Phone
- (808) 280-1776
- NPI assigned
- Aug 25, 2022
- 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 | 26867 | OR | Primary |
Addresses
Primary practice location
57031 Ponderosa Road
BLD 27 Ste M2
Sunriver, OR 97707
Mailing address
16675 Masten Mill Drive
La Pine, OR 97739
Phone (808) 280-1776
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 |
|---|---|---|---|
| 26867 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massage in Central Oregon LLC | 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
- Sunriver, OR
- NPI 1811686454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1841919503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16675 MASTEN MILL DRIVE",
"city": "LA PINE",
"state": "OR",
"postal_code": "97739",
"telephone_number": "808-280-1776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57031 PONDEROSA ROAD",
"address_2": "BLD 27 STE M2",
"city": "SUNRIVER",
"state": "OR",
"postal_code": "97707",
"telephone_number": "808-280-1776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AUTEUIL",
"first_name": "STEFAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-25",
"last_updated": "2024-04-09",
"certification_date": "2024-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "26867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunriver, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.