Active NPI
Tiffany R Phillips, LMT
- Massage Therapist
- Boise, ID
National Provider Identifier
1952810848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS-2762
- Practice address
- 760 E Warm Springs Ave
Boise, ID 83712-6476 - Phone
- (571) 263-5258
- NPI assigned
- Sep 24, 2017
- Last updated
- Sep 24, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAS-2762 | ID | Primary |
Addresses
Primary practice location
760 E Warm Springs Ave
Boise, ID 83712-6476
Mailing address
8089 S Diego Way
Boise, ID 83709-7378
Phone (571) 263-5258
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
| License | State | Type | Specialty |
|---|---|---|---|
| MAS-2762 | ID | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506211200000",
"number": "1952810848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8089 S DIEGO WAY",
"city": "BOISE",
"state": "ID",
"postal_code": "837097378",
"telephone_number": "571-263-5258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 E WARM SPRINGS AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837126476",
"telephone_number": "571-263-5258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TIFFANY",
"middle_name": "R",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-24",
"last_updated": "2017-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MAS-2762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.