Individual provider Active NPI

Tanille Marie Spencer, LMT

  • Massage Therapist
  • Saint Albans, WV
National Provider Identifier
1922533793
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2015-3329 Issued in WV
Practice address
89 Olde Main PLZ
Saint Albans, WV 25177-2707
Phone
(304) 437-0690
NPI assigned
Apr 28, 2017
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 2015-3329 WV Primary

Addresses

Primary practice location

89 Olde Main PLZ
Saint Albans, WV 25177-2707

Mailing address

2550 Conner Ave
Hurricane, WV 25526-1024
Phone (304) 437-0690

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
2015-3329WVMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Healing Massage, LLC Massage Therapist CurrentSince Feb 25, 2024 Accepting new patients
Pure Serenity Day Spa, LLC Massage Therapist Past Accepting new patients

Locations

3761 Teays Valley Rd
Ste C
Hurricane, WV 25526
Phone (304) 437-0690

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1922533793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 CONNER AVE",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255261024",
            "telephone_number": "304-437-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 OLDE MAIN PLZ",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772707",
            "telephone_number": "304-437-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "TANILLE",
        "middle_name": "MARIE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "2015-3329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.