EPIC WELLNESS NW (NPI# 1740661636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740661636 |
| Entity Type | Organization |
| Organization Name | EPIC WELLNESS NW |
| Practice Address |
820 Crater Lake Ave Suite 113 Medford OR 97504-6581 |
| Practice Telephone | 5417701606 |
| Mailing Telephone | 5417701606 |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2017-03-22 |
| Authorized Official Name | CALLIE KNIGHT (OWNER/MANAGER) |
| Authorized Official Telephone | 5417701606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 225700000X | Massage Therapist | 20067 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225700000X | Massage Therapist | 20099 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | EPIC WELLNESS NW LLC | 820 Crater Lake Ave Ste 113, Medford, OR 97504 |
| Street Address |
820 CRATER LAKE AVE SUITE 113 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578641510 | Richard Phillip Sommers | Chiropractor | 820 Crater Lake Ave, Suite 106, Medford, OR 97504 | 2006-11-01 |
| 1053749911 | Blake Knight | Massage Therapist | 820 Crater Lake Ave, Suite 113, Medford, OR 97504-6581 | 2013-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| 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 |
|---|---|---|---|---|
| 1720686488 | Olivia Berryessa | Massage Therapist | 709 N Phoenix Rd, Medford, OR 97504-9488 | 2020-10-15 |
| 1922613744 | Danielle Roche | Massage Therapist | 8 Big Cone Ln, Medford, NY 11763-4229 | 2020-09-09 |
| 1437768603 | Corinna Horst | Massage Therapist | 1104 E Jackson St, Medford, OR 97504-7029 | 2020-07-23 |
| 1366064685 | Moira Jean Volz I | Massage Therapist | 718 Cardley Ave, Medford, OR 97504-6124 | 2020-05-08 |
| 1194346619 | Pricilla Madera | Massage Therapist | 1345 Center Dr Unit A, Medford, OR 97501-7945 | 2020-05-06 |
| 1497390322 | Tracy Lynn Deal | Massage Therapist | 1550 Biddle Rd Ste C, Medford, OR 97504-4691 | 2019-11-14 |
| 1265075196 | Stephanie Renee Myers | Massage Therapist | 3190 State St Ste 101, Medford, OR 97504-8498 | 2019-10-23 |
| 1720546658 | Anatrypsis Massage and Wellness | Massage Therapist | 711 E Main St Ste 16, Medford, OR 97504-7139 | 2019-03-11 |
| 1457819609 | Gordon Pilotte | Massage Therapist | 5 Boston Ave Ste B, Medford, MA 02155-6721 | 2019-03-06 |
| 1174087092 | Andrey Pravda | Massage Therapist | 2924 Seckel St, Medford, OR 97504-8150 | 2019-01-24 |
| Find all providers in MEDFORD | ||||
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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.