AMBER DAWN PETERSON LMT NPI 1003448960

Massage Therapist in Springfield, MO

Individual Female Massage Therapist

About AMBER PETERSON

Amber Peterson is a provider established in Springfield, Missouri and her medical specialization is massage therapist. The NPI number of Amber Peterson is 1003448960 and was assigned on February 2020. The practitioner's primary taxonomy code is 225700000X with license number 2019029836 (MO). The provider is registered as an individual and her NPI record was last updated February 2020.

NPI

1003448960

Provider Name AMBER DAWN PETERSON LMT
Provider Location Address1440 W REPUBLIC RD SPRINGFIELD, MO 65807
Provider Mailing Address2707 W BRIDLEWOOD TRL OZARK, MO 65721
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date02-09-2020
Last Update Date02-09-2020

Primary Taxonomy

Taxonomy Code225700000X
ClassificationMassage Therapist
TypeRespiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.2019029836
License StateMO
Taxonomy DescriptionAn individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Business Address

AMBER DAWN PETERSON LMT
1440 W REPUBLIC RD
SPRINGFIELD, MO
ZIP 65807
Phone: (417) 719-1591

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Mailing Address

AMBER DAWN PETERSON LMT
2707 W BRIDLEWOOD TRL
OZARK, MO
ZIP 65721
Phone: (417) 942-9885

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1154739738MATT STUNKEL DDS, LLC
Organization
Dentist1440 W REPUBLIC RD STE:144
SPRINGFIELD, MO 65807
(417) 720-4075
1770940207 MATTHEW CHARLES MAURER D.C.
Individual
Chiropractor1440 W REPUBLIC RD SUITE 112
SPRINGFIELD, MO 65807
(417) 889-2225

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.