Duc (Douglas) Tran

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

8424 Issued in AR

Practice address

1615 E Centerton Blvd
Centerton, AR 72719-9208

Phone

(479) 936-1668

NPI assigned

Apr 23, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1972123636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 NW APPLE BLOSSOM",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128424",
            "telephone_number": "479-936-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 E CENTERTON BLVD",
            "city": "CENTERTON",
            "state": "AR",
            "postal_code": "727199208",
            "telephone_number": "479-936-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "DUC (DOUGLAS)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "AR",
            "license": "8424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Centerton",
            "affiliation": "N",
            "address_1": "1615 E Centerton Blvd",
            "city": "Centerton",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727199208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jackie B Tesch
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• Jason Austin Tolbert, SRNA
• Angela D Traylor
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• Mindy Kay Walker

• Massage Therapist in Centerton, AR
• Providers in Centerton, AR by specialty
• Massage Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.