Active NPI
Yuriy Khoma
- Massage Therapist
- Plainville, CT
National Provider Identifier
1902613185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 11425
- Practice address
- 23 Hart PL Apt 3
Plainville, CT 06062-2861 - Phone
- (860) 543-1255
- NPI assigned
- Dec 12, 2024
- Last updated
- Dec 12, 2024
- 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 | 11425 | CT | Primary |
Addresses
Primary practice location
23 Hart PL Apt 3
Plainville, CT 06062-2861
Mailing address
23 Hart PL Apt 3
Plainville, CT 06062-2861
Phone (860) 543-1255
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 |
|---|---|---|---|
| 11425 | CT | MD | Massage Therapist |
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": "1902613185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 HART PL APT 3",
"city": "PLAINVILLE",
"state": "CT",
"postal_code": "060622861",
"telephone_number": "860-543-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 HART PL APT 3",
"city": "PLAINVILLE",
"state": "CT",
"postal_code": "060622861",
"telephone_number": "860-543-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOMA",
"first_name": "YURIY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"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": "CT",
"license": "11425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainville, CT
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.