Individual provider Active NPI

Rhonda Deadrick, LMT

  • Massage Therapist
  • Flagstaff, AZ
National Provider Identifier
1992486369
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-08629 Issued in AZ
Practice address
2323 E Greenlaw LN Ste 7B
Flagstaff, AZ 86004-1849
Phone
(480) 845-2895
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT-08629 AZ Primary

Addresses

Primary practice location

2323 E Greenlaw LN Ste 7B
Flagstaff, AZ 86004-1849

Mailing address

2352 Fourth St Box 321
Flagstaff, AZ 86004-3712
Phone (928) 526-4653

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

LicenseStateTypeSpecialty
MT-08629AZMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1992486369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 FOURTH ST BOX 321",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043712",
            "telephone_number": "928-526-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 E GREENLAW LN STE 7B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041849",
            "telephone_number": "480-845-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEADRICK",
        "first_name": "RHONDA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-08629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.