Active NPI
Theresa Bender
- Massage Therapist
- Kingwood, WV
National Provider Identifier
1073331005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2011-2898
- Practice address
- 204 W Main St Ste 2
Kingwood, WV 26537-1419 - Phone
- (304) 594-6774
- NPI assigned
- Sep 30, 2024
- 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 | 2011-2898 | WV | Primary |
Addresses
Primary practice location
204 W Main St Ste 2
Kingwood, WV 26537-1419
Mailing address
PO Box 93
Newburg, WV 26410-0093
Phone (703) 615-6024
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 |
|---|---|---|---|
| 2011-2898 | WV | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1073331005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 93",
"city": "NEWBURG",
"state": "WV",
"postal_code": "264100093",
"telephone_number": "703-615-6024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 W MAIN ST STE 2",
"city": "KINGWOOD",
"state": "WV",
"postal_code": "265371419",
"telephone_number": "304-594-6774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENDER",
"first_name": "THERESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-30",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WV",
"license": "2011-2898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingwood, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.