Individual provider Active NPI

Ava Motter, CMP

  • Massage Therapist
  • Santa Rosa, CA
National Provider Identifier
1861209058
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
54654 Issued in CA
Practice address
808 Donahue St
Santa Rosa, CA 95401-5434
Phone
(707) 322-6515
NPI assigned
Dec 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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 54654 CA Primary

Addresses

Primary practice location

808 Donahue St
Santa Rosa, CA 95401-5434

Mailing address

5006 Boulder LN
Santa Rosa, CA 95405-7417
Phone (707) 694-8913

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

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1861209058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 BOULDER LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057417",
            "telephone_number": "707-694-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 DONAHUE ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015434",
            "telephone_number": "707-322-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTER",
        "first_name": "AVA",
        "credential": "CMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "54654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.

Verify at the official NPI Registry.