Active NPI
Mary Alyce Cross, CMT
- Massage Therapist
- Ignacio, CO
National Provider Identifier
1962706630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 6304
- Practice address
- 14324 US Highway 172N
Ignacio, CO 81137 - Phone
- (970) 563-6267
- NPI assigned
- Jan 10, 2011
- Last updated
- Jan 10, 2011
- 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 | 6304 | CO | Primary |
Addresses
Primary practice location
14324 US Highway 172N
Ignacio, CO 81137
Mailing address
120 Pine Cone Dr
Bayfield, CO 81122-9201
Phone (970) 769-5776
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 |
|---|---|---|---|
| 6304 | CO | MD | Internist Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294617600000",
"number": "1962706630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 PINE CONE DR",
"city": "BAYFIELD",
"state": "CO",
"postal_code": "811229201",
"telephone_number": "970-769-5776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14324 US HIGHWAY 172N",
"city": "IGNACIO",
"state": "CO",
"postal_code": "81137",
"telephone_number": "970-563-6267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSS",
"first_name": "MARY",
"middle_name": "ALYCE",
"name_prefix": "Ms.",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-10",
"last_updated": "2011-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "6304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ignacio, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.