Active NPI
Kristen Wolf
- Massage Therapist
- Fort Wayne, IN
National Provider Identifier
1073982690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT21304891
- Practice address
- 5111 N Bend Dr
Fort Wayne, IN 46804-1753 - Phone
- (260) 437-0951
- NPI assigned
- Sep 24, 2015
- 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 | MT21304891 | IN | Primary |
Addresses
Primary practice location
5111 N Bend Dr
Fort Wayne, IN 46804-1753
Mailing address
2415 Union Chapel Rd
Fort Wayne, IN 46845-9266
Phone (260) 437-0951
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 |
|---|---|---|---|
| MT21304891 | IN | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443052800000",
"number": "1073982690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 UNION CHAPEL RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468459266",
"telephone_number": "260-437-0951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5111 N BEND DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468041753",
"telephone_number": "260-437-0951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "KRISTEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-24",
"last_updated": "2015-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IN",
"license": "MT21304891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.