Individual provider Active NPI

Leslie Crandall, LMT

  • Massage Therapist
  • Anchorage, AK
National Provider Identifier
1053879288
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
101767 Issued in AK
Practice address
500 E Benson Blvd Ste 103500E
Anchorage, AK 99503-4148
Phone
(907) 561-4474
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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 101767 AK Primary

Addresses

Primary practice location

500 E Benson Blvd Ste 103500E
Anchorage, AK 99503-4148

Mailing address

500 E Benson Blvd Ste 103500E
Anchorage, AK 99503-4148
Phone (907) 561-4474

Other identifiers 1

IdentifierTypeStateIssuer
101767OtherAKMASSAGE THERAPIST

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
101767AKMDMassage Therapist

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19808/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1053879288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E BENSON BLVD STE 103500E",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034148",
            "telephone_number": "907-561-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E BENSON BLVD STE 103500E",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034148",
            "telephone_number": "907-561-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "LESLIE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "101767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPIST",
            "identifier": "101767",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.