Active NPI
Todd Borron, L.M.T.
- Massage Therapist
- Bonne Terre, MO
National Provider Identifier
1871879155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2003006161
- Practice address
- 203 NE Main St
Suite 4
Bonne Terre, MO 63628-1775 - Phone
- (573) 692-0000
- NPI assigned
- Oct 31, 2011
- 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 | 2003006161 | MO | Primary |
Addresses
Primary practice location
203 NE Main St
Suite 4
Bonne Terre, MO 63628-1775
Mailing address
203 NE Main St
Suite 4
Bonne Terre, MO 63628-1775
Phone (573) 692-0000
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 |
|---|---|---|---|
| 2003006161 | MO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1871879155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 NE MAIN ST",
"address_2": "SUITE 4",
"city": "BONNE TERRE",
"state": "MO",
"postal_code": "636281775",
"telephone_number": "573-692-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 NE MAIN ST",
"address_2": "SUITE 4",
"city": "BONNE TERRE",
"state": "MO",
"postal_code": "636281775",
"telephone_number": "573-692-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORRON",
"first_name": "TODD",
"name_prefix": "Mr.",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MO",
"license": "2003006161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonne Terre, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.