Individual provider Active NPI

Cynthia Bradburn, LMT

  • Massage Therapist
  • Bedford, TX
National Provider Identifier
1912304767
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT116794 Issued in TX
Practice address
1501 Airport Fwy Ste 207
Bedford, TX 76021-6626
Phone
(817) 266-1379
NPI assigned
Nov 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 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 MT116794 TX Primary

Addresses

Primary practice location

1501 Airport Fwy Ste 207
Bedford, TX 76021-6626

Mailing address

6105 N Hill LN
Fort Worth, TX 76135-1318
Phone (817) 266-1379

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
MT116794TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1912304767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 N HILL LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761351318",
            "telephone_number": "817-266-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 AIRPORT FWY STE 207",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216626",
            "telephone_number": "817-266-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURN",
        "first_name": "CYNTHIA",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT116794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.