Active NPI
Kristi Carlough, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1083079859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 24493
- Practice address
- 1831 SE 7TH Ave
Portland, OR 97214-3578 - Phone
- (503) 929-3525
- NPI assigned
- Dec 22, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 24493 | OR | Primary |
Addresses
Primary practice location
1831 SE 7TH Ave
Portland, OR 97214-3578
Mailing address
1831 SE 7TH Ave
Portland, OR 97214-3578
Phone (503) 929-3525
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24493 | Other | OR | STATE LICENSE |
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 |
|---|---|---|---|
| 24493 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1083079859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1831 SE 7TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143578",
"telephone_number": "503-929-3525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1831 SE 7TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143578",
"telephone_number": "503-929-3525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLOUGH",
"first_name": "KRISTI",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-22",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "24493",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "24493",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.