Individual provider Active NPI

Stephanie Wiberg

  • Massage Therapist
  • Wasilla, AK
National Provider Identifier
1033640875
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
102013 Issued in AK
Practice address
400 N Main St
Wasilla, AK 99654-7018
Phone
(907) 373-2022
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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 102013 AK Primary

Addresses

Primary practice location

400 N Main St
Wasilla, AK 99654-7018

Mailing address

HC 89 Box 8193
Talkeetna, AK 99676-9701
Phone (415) 419-4272

Other names 1

  • Stephanie Waite Former name

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
102013AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Chiropractic Clinic, Inc PastSince Oct 17, 2007 Accepting new patients

Organizations & group practices 1

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1033640875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 89 BOX 8193",
            "city": "TALKEETNA",
            "state": "AK",
            "postal_code": "996769701",
            "telephone_number": "415-419-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547018",
            "telephone_number": "907-373-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBERG",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "102013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WAITE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.