Revive Massage and Wellness

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

REVIVE MASSAGE AND WELLNESS

Practice address

2956 Ginnala Dr Ste 205
Loveland, CO 80538-7825

Phone

(970) 614-4218

NPI assigned

Feb 4, 2020

Last updated

Feb 4, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shayla JohnsonNPI 1528419942

Title

Owner/Operator

Phone

(970) 443-5645

Specialties & licenses 1

Addresses

Other names 1

• Revive Massage Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shayla Johnson, LMT

  • Massage Therapist
  • Loveland, CO
  • NPI 1528419942
  NPD Authorized official

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1952933343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2956 GINNALA DR STE 205",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805387825",
            "telephone_number": "970-614-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2956 GINNALA DR STE 205",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805387825",
            "telephone_number": "970-614-4218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1019 37th Avenue Ct Unit 2",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806342567",
            "country_code": "US",
            "telephone_number": "970-614-4218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE MASSAGE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHAYLA",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "970-443-5645"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Massage",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Massage Therapist in Loveland, CO
• Providers in Loveland, CO by specialty
• Massage Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.