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Tammy Cornwell

Individual provider Active NPI Massage Therapist · Rapid City, SD

NPI 1932845708 · NPPES record last updated May 5, 2022

Key facts

NPI
1932845708
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT11664 (MT)
Practice address
2525 W Main St Ste 210
Rapid City, SD 57702-2439
Phone
(605) 399-2273
NPI assigned
May 5, 2022
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT11664MTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Psychology, LLC Current
since Apr 21, 2024		 Accepting new patients
Bahr Chiropractic Wellness Center LLC Past
since May 8, 2022		 Accepting new patients

Locations

2525 W Main St
Ste 210
Rapid City, SD 57702
Phone (605) 399-2273

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT11664 MT Yes

Addresses

Primary practice location

2525 W Main St Ste 210
Rapid City, SD 57702-2439

Mailing address

2525 W Main St Ste 210
Rapid City, SD 57702-2439
Phone (605) 399-2273

Other providers in Rapid City, SD

All providers in Rapid City, SD · Massage Therapist in South Dakota

Sources for this page

Verify at the official NPI Registry.