Active NPI
Sherry May Koontz, LMT
- Massage Therapist
- Azle, TX
National Provider Identifier
1043490709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT004364
- Practice address
- 12157 Liberty School Rd
Azle, TX 76020-5413 - Phone
- (817) 444-9173
- NPI assigned
- Nov 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT004364 | TX | Primary |
Addresses
Primary practice location
12157 Liberty School Rd
Azle, TX 76020-5413
Mailing address
12157 Liberty School Rd
Azle, TX 76020-5413
Phone (817) 444-9173
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT004364 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276041600000",
"number": "1043490709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12157 LIBERTY SCHOOL RD",
"city": "AZLE",
"state": "TX",
"postal_code": "760205413",
"telephone_number": "817-444-9173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12157 LIBERTY SCHOOL RD",
"city": "AZLE",
"state": "TX",
"postal_code": "760205413",
"telephone_number": "817-444-9173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOONTZ",
"first_name": "SHERRY",
"middle_name": "MAY",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-11",
"last_updated": "2010-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT004364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.