Active NPI
Kendra Crombez
- Massage Therapist
- Clinton, MI
National Provider Identifier
1053856518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7501008498
- Practice address
- 12285 Fisk Rd
Clinton, MI 49236-9624 - Phone
- (517) 673-0744
- NPI assigned
- Dec 19, 2016
- Last updated
- Mar 23, 2023
- 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 | 7501008498 | MI | Primary |
Addresses
Primary practice location
12285 Fisk Rd
Clinton, MI 49236-9624
Mailing address
12285 Fisk Rd
Clinton, MI 49236-9624
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 |
|---|---|---|---|
| 7501008498 | MI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Way of Life LLC | Massage Therapist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1053856518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12285 FISK RD",
"city": "CLINTON",
"state": "MI",
"postal_code": "492369624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12285 FISK RD",
"city": "CLINTON",
"state": "MI",
"postal_code": "492369624",
"telephone_number": "517-673-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROMBEZ",
"first_name": "KENDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-19",
"last_updated": "2023-03-23",
"certification_date": "2023-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MI",
"license": "7501008498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.