Active NPI
Rosemarie Waters, LMP
- Massage Therapist
- Soldotna, AK
National Provider Identifier
1073755237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 101540
- Practice address
- 315 S. Kobuk St.
Suite #2
Soldotna, AK 99669 - Phone
- (907) 420-0820
- Fax
- (253) 639-4809
- NPI assigned
- Apr 1, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | MA60055196 | WA | |
| Massage Therapist | 225700000X | 101540 | AK | Primary |
Addresses
Primary practice location
315 S. Kobuk St.
Suite #2
Soldotna, AK 99669
Mailing address
PO Box 748
Kenai, AK 99611-0748
Phone (719) 650-5541
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 |
|---|---|---|---|
| MA60055196 | WA | MD | Community Health Worker |
| 101540 | AK | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487289600000",
"number": "1073755237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 748",
"city": "KENAI",
"state": "AK",
"postal_code": "996110748",
"telephone_number": "719-650-5541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 S. KOBUK ST.",
"address_2": "SUITE #2",
"city": "SOLDOTNA",
"state": "AK",
"postal_code": "99669",
"telephone_number": "907-420-0820",
"fax_number": "253-639-4809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "ROSEMARIE",
"name_prefix": "Miss",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-01",
"last_updated": "2017-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "WA",
"license": "MA60055196",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AK",
"license": "101540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Soldotna, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.