Individual provider Active NPI

Charles David Dunnell, LMT, PFT

  • Massage Therapist
  • Boulder, CO
National Provider Identifier
1942925482
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT.0024942 Issued in CO
Practice address
933 Alpine Ave
Boulder, CO 80304-3305
Phone
(720) 438-0450
NPI assigned
Oct 6, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 MT.0024942 CO Primary

Addresses

Primary practice location

933 Alpine Ave
Boulder, CO 80304-3305

Mailing address

7911 W Sussex CT
Niwot, CO 80503-7616
Phone (720) 438-0450

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
MT.0024942COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1942925482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7911 W SUSSEX CT",
            "city": "NIWOT",
            "state": "CO",
            "postal_code": "805037616",
            "telephone_number": "720-438-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 ALPINE AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043305",
            "telephone_number": "720-438-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNELL",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LMT, PFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0024942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.