ISLAND THERAPEUTIC MASSAGE (NPI# 1790035749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790035749 |
| Entity Type | Organization |
| Organization Name | ISLAND THERAPEUTIC MASSAGE |
| Practice Address |
6043 Hudson Rd Suite 125 Woodbury MN 55125-1018 |
| Practice Telephone | 6127350610 |
| Mailing Telephone | 6127350610 |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-19 |
| Authorized Official Name | VICTORIA STOVALL (OWNER/OPERATOR) |
| Authorized Official Telephone | 6127350610 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
6043 HUDSON RD SUITE 125 |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-1018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972580058 | Michelle M Murphy | Nurse Practitioner | 6043 Hudson Rd, Suite 220, Woodbury, MN 55125 | 2005-12-29 |
| 1427424241 | Jessica Marie Backowski | Counselor | 6043 Hudson Rd, Woodbury, MN 55125-1018 | 2015-08-16 |
| 1477929438 | Janet Kelson | Marriage & Family Therapist | 6043 Hudson Rd, Suite 140p, Woodbury, MN 55125-1018 | 2015-08-13 |
| 1609256122 | B Tek, LLC | Clinical Medical Laboratory | 6043 Hudson Rd, Suite 220, Woodbury, MN 55125-1018 | 2015-06-01 |
| 1609113083 | Kb Counseling Evaluation Mediation Services | Marriage & Family Therapist | 6043 Hudson Rd, Suite 140p, Woodbury, MN 55125-1018 | 2013-01-06 |
| 1427320746 | Victoria Stovall | Specialist | 6043 Hudson Rd, Suite 125, Woodbury, MN 55125-1018 | 2012-02-01 |
| 1972874766 | Jean Edith Eich | Psychologist | 6043 Hudson Rd, Suite 290, Woodbury, MN 55125-1018 | 2012-01-25 |
| 1548539786 | Hope Village, LLC | Social Worker | 6043 Hudson Rd, Suite 372, Woodbury, MN 55125-1018 | 2011-12-16 |
| 1356640403 | Barbara Kay Snyder | Counselor | 6043 Hudson Rd, Suite 290, Woodbury, MN 55125-1018 | 2011-03-15 |
| 1144531245 | Rosella Collins-puoch | Social Worker | 6043 Hudson Rd, Suite 372, Woodbury, MN 55125-1018 | 2010-06-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780201921 | Heidi Dawn Dietl | Massage Therapist | 234 Crossways Park Dr, Woodbury, NY 11797-2015 | 2020-07-04 |
| 1043846751 | Laura Jean Abernathy | Massage Therapist | 7803 Afton Rd Ste 17, Woodbury, MN 55125-1507 | 2020-03-14 |
| 1861902579 | Johanne Francine Rousseau-holt | Massage Therapist | 670 Main St S, Woodbury, CT 06798-3738 | 2017-10-07 |
| 1184979957 | Debora Born | Massage Therapist | 7200 Robinwood Draw, Woodbury, MN 55125-2772 | 2012-07-18 |
| 1679878458 | Jessica I Klein | Massage Therapist | 26 Chestnut Ln, Woodbury, NY 11797-1911 | 2011-01-25 |
| 1942505078 | Melissa Ann Allen | Massage Therapist | 3529 John Bragg Hwy, Woodbury, TN 37190-7117 | 2011-01-20 |
| 1184751539 | Gigi J. Decker | Massage Therapist | 6025 Lake Road, Woodbury, MN 55125 | 2007-02-27 |
| 1871125120 | Zoua Vang | Massage Therapist | 1687 Woodlane Dr, Woodbury, MN 55125-3045 | 2020-02-05 |
| 1497245237 | Jessica Renee Karoff | Massage Therapist | 1687 Woodlane Dr Ste 201, Woodbury, MN 55125-3062 | 2018-05-17 |
| 1124528039 | Joshua Williams | Massage Therapist | 111 W Main St, Woodbury, TN 37190-1143 | 2018-02-16 |
| Find all providers in WOODBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.