Sue Kelly, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

33.005297 Issued in OH

Practice address

123 State Route 3
Sunbury, OH 43074-6900

Phone

(740) 956-4301

Fax

(740) 965-5182

NPI assigned

Jan 22, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sue Westendorf Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1043800014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 STATE ROUTE 3",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430746900",
            "telephone_number": "740-956-4301",
            "fax_number": "740-965-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 STATE ROUTE 3",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430746900",
            "telephone_number": "740-956-4301",
            "fax_number": "740-965-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SUE",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.005297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF WORKER'S COMPENSATION",
            "identifier": "1172068-0001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUE",
            "last_name": "WESTENDORF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Massage Therapist in Sunbury, OH
• Providers in Sunbury, OH by specialty
• Massage Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.