Individual provider Active NPI

Kelly A Robison, LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1073015129
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60338577 Issued in WA
Practice address
4459 Fremont Ave North
Suite 2
Seattle, WA 98103
Phone
(206) 501-2092
Fax
(206) 708-6638
NPI assigned
Mar 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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 MA60338577 WA Primary

Addresses

Primary practice location

4459 Fremont Ave North
Suite 2
Seattle, WA 98103

Mailing address

4459 Fremont Ave North
Suite 2
Seattle, WA 98103
Phone (206) 501-2092

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
MA60338577WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matkel Corporation 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1073015129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4459 FREMONT AVE NORTH",
            "address_2": "SUITE 2",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98103",
            "telephone_number": "206-501-2092",
            "fax_number": "206-708-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4459 FREMONT AVE NORTH",
            "address_2": "SUITE 2",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98103",
            "telephone_number": "206-501-2092",
            "fax_number": "206-708-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60338577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.