NPIMap

Individual provider Active NPI

Kelly Ann Barrett, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1033545686
Registry record updated Sep 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18707 Issued in OR
Practice address
2526 NE 15TH Ave
Portland, OR 97212-4222
Phone
(503) 288-7668
NPI assigned
Sep 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2013

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 18707 OR Primary

Addresses

Primary practice location

2526 NE 15TH Ave
Portland, OR 97212-4222

Mailing address

525 SE 46TH Ave
Portland, OR 97215-1701
Phone (609) 332-5059

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

State licenses

LicenseStateTypeSpecialty
18707ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Root Whole Body Health, Inc Massage Therapist Past Accepting new patients
Root Whole Body Health, Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379203200000",
    "number": "1033545686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SE 46TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151701",
            "telephone_number": "609-332-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 NE 15TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972124222",
            "telephone_number": "503-288-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-15",
        "last_updated": "2013-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "18707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2013; 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.