Jospeh Provo, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

185638 Issued in AK

Practice address

108 E Arctic Ave
Palmer, AK 99645-6254

Phone

(907) 745-4357

Fax

(907) 745-4606

NPI assigned

Jan 11, 2022

Last updated

Jan 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bionic Chiropractic

  • Chiropractor
  • Palmer, AK
  • NPI 1750886016
  NPD (past)

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1912658949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E ARCTIC AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456254",
            "telephone_number": "907-745-4357",
            "fax_number": "907-745-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E ARCTIC AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456254",
            "telephone_number": "907-745-4357",
            "fax_number": "907-745-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVO",
        "first_name": "JOSPEH",
        "credential": "MT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "185638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Palmer",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Outpatient",
            "address_1": "108 E Arctic Ave",
            "city": "Palmer",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996456254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Precision Health, LLC (Precision Health Alaska)
• Presbyterian Hospitality House
• James H Price Jr., D.O.
• Providence Health & Services - Washington (Providence Matanuska Health Care)
• Genie Sabas Provo
• Psychology Solutions, LLC
• Andrew Richard Pulliam, M.D.
• Alexandra Meghan Pultz
• Cadden Lawrence Pylant
• Thomas W Quimby, MD

• Massage Therapist in Palmer, AK
• Providers in Palmer, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.