Inner Health Spa LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

INNER HEALTH SPA LLC

Practice address

1733 S 5TH St
Springfield, IL 62703-3116

Phone

(217) 572-1611

NPI assigned

Jul 22, 2024

Last updated

Jul 22, 2024By 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

Michelle Ann Bullock, LMT

Title

Owner/Massage Therapist

Phone

(217) 572-1611

Specialties & licenses 2

Addresses

Other names 1

• Inner Health Spa LLC Other name

Locations

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1982432126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 S 5TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627033116",
            "telephone_number": "217-572-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 S 5TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627033116",
            "telephone_number": "217-572-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER HEALTH SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-21",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "217-572-1611",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Health Spa LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Massage Therapist in Springfield, IL
• Providers in Springfield, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.