NPIMap

Individual provider Active NPI

Connie Oliver

  • Massage Therapist
  • Espanola, NM
National Provider Identifier
1891129672
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7245 Issued in NM
Practice address
510 N Paseo de Onate
Espanola, NM 87532-2618
Phone
(505) 753-3369
Fax
(505) 753-4006
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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 7245 NM Primary

Addresses

Primary practice location

510 N Paseo de Onate
Espanola, NM 87532-2618

Mailing address

510 N Paseo de Onate
Espanola, NM 87532-2618
Phone (505) 753-3369

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
7245NMMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
GRD Health Clinic LLC Past Accepting new patients
Shakti Clinic LLC Massage Therapist Past 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": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1891129672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322618",
            "telephone_number": "505-753-3369",
            "fax_number": "505-753-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322618",
            "telephone_number": "505-753-3369",
            "fax_number": "505-753-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "CONNIE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "7245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Espanola, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.