Terra Organic Spa

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

016959 Issued in NY

Legal business name

TERRA ORGANIC SPA

Practice address

201 Highbridge St
Fayetteville, NY 13066-1903

Phone

(315) 637-0767

NPI assigned

Jan 31, 2018

Organization subpart

No

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

Authorized official

Name

Rachel M McClean, LMT

Title

Owner

Phone

(315) 440-7744

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1942708359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HIGHBRIDGE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661903",
            "telephone_number": "315-440-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HIGHBRIDGE ST",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661903",
            "telephone_number": "315-637-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRA ORGANIC SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "MCCLEAN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-440-7744",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "016959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.