Individual provider Active NPI

Kathryn Broeker

  • Massage Therapist
  • Niagara Falls, NY
National Provider Identifier
1013379247
Registry record updated Mar 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
029153 Issued in NY
Practice address
920 Main St
Niagara Falls, NY 14301-1110
Phone
(716) 940-0411
NPI assigned
Mar 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2016

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 029153 NY Primary

Addresses

Primary practice location

920 Main St
Niagara Falls, NY 14301-1110

Mailing address

PO Box 373
Niagara Falls, NY 14302-0373

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

NPI Registry JSON

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

{
    "created_epoch": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458950400000",
    "number": "1013379247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143020373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MAIN ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011110",
            "telephone_number": "716-940-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROEKER",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-26",
        "last_updated": "2016-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "029153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2016; 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.