Individual provider Active NPI

Tana Kradolfer, NCTMB

  • Massage Therapist
  • Bozeman, MT
National Provider Identifier
1104199082
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
49 Issued in MT
Practice address
332 Gallatin Park Dr
Bozeman, MT 59715-7909
Phone
(406) 539-3163
NPI assigned
Feb 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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 49 MT Primary

Addresses

Primary practice location

332 Gallatin Park Dr
Bozeman, MT 59715-7909

Mailing address

5075 Clearview Rd
Belgrade, MT 59714-8626
Phone (406) 388-4974

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
49MTMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1104199082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5075 CLEARVIEW RD",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597148626",
            "telephone_number": "406-388-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 GALLATIN PARK DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597157909",
            "telephone_number": "406-539-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRADOLFER",
        "first_name": "TANA",
        "name_prefix": "Mrs.",
        "credential": "NCTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MT",
            "license": "49",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.