Individual provider Active NPI

Ti'Ia McKenzie-Dantities Friisvall, LMT

  • Massage Therapist
  • Grand Rapids, MI
National Provider Identifier
1912868902
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501016458 Issued in MI
Practice address
616 Fulton St W Apt 319
Grand Rapids, MI 49504-6399
Phone
(906) 201-7773
NPI assigned
Nov 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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 7501016458 MI Primary

Addresses

Primary practice location

616 Fulton St W Apt 319
Grand Rapids, MI 49504-6399

Mailing address

616 Fulton St W Apt 319
Grand Rapids, MI 49504-6399

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
7501016458MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1912868902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FULTON ST W APT 319",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495046399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 FULTON ST W APT 319",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495046399",
            "telephone_number": "906-201-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIISVALL",
        "first_name": "TI'IA",
        "middle_name": "MCKENZIE-DANTITIES",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501016458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.