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MOUNTAIN STATE MEDICAL MASSAGE
NPI 1558089904
Massage Therapist in Centennial, CO

Active since August 19, 2022
6970 S HOLLY CIR, CENTENNIAL, CO 80112(720) 841-1042 Get Directions Write a Review

NPPES record last updated: January 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 18, 2023, Oct 1, 2022, Aug 19, 2022 (3 updates tracked since 2022).

About Mountain State Medical Massage NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN STATE MEDICAL MASSAGE (NPI 1558089904) is a healthcare organization registered as a massage therapist in Centennial, Colorado and active in the NPI registry since August 2022. The organization lists Jenny M Nickerson, Owner, as its authorized official.

NPPES Registry Identity

NPI1558089904
Entity TypeOrganization
Primary Taxonomy225700000X
Legal Business NameMOUNTAIN STATE MEDICAL MASSAGE
Location Address6970 S HOLLY CIRCentennial, CO 80112-6296
Mailing Address4767 S Odessa StCentennial, CO 80015-3449 · (720) 841-1042
Phone(720) 841-1042
Organization SubpartNo
Authorized OfficialJenny M NickersonOwner · (720) 841-1042
Enumeration DateAugust 19, 2022
Last NPPES UpdateJanuary 18, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2023
✔ NPI 1558089904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
Definition
An 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.
6970 S HOLLY CIR, Centennial, CO 80112
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Other Names 1

Former Legal Business NameMountain State Medical Massage

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEDVITAE LLC
Durable Medical Equipment & Medical Supplies
6970 S HOLLY CIR, ST 200
CENTENNIAL, CO 80112
Arapahoe County (720) 500-2075
JENNY NICKERSON
Massage Therapist
6970 S HOLLY CIR
CENTENNIAL, CO 80112
Arapahoe County (720) 841-1042
KATHRYN LAINE BUCZEK
Speech-Language Pathologist
6970 S HOLLY CIR
CENTENNIAL, CO 80112
Arapahoe County (720) 287-4185

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mountain State Medical Massage's NPI number?

The NPI number for Mountain State Medical Massage is 1558089904. It was assigned to this organization in the NPPES registry on August 19, 2022.

Where is Mountain State Medical Massage located?

Mountain State Medical Massage is located at 6970 S Holly Cir, Centennial, CO 80112. The listed phone number is (720) 841-1042.

What is Mountain State Medical Massage's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Mountain State Medical Massage was last updated on January 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.