Individual provider Active NPI

Kalesh Weaver, LMT

  • Massage Therapist
  • Talent, OR
National Provider Identifier
1114274685
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
16981 Issued in OR
Practice address
7676 Adams Rd
Talent, OR 97540-7839
Phone
(541) 535-3890
NPI assigned
Aug 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 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 16981 OR Primary

Addresses

Primary practice location

7676 Adams Rd
Talent, OR 97540-7839

Mailing address

312 East Main Street
Talent, OR 97540

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
16981ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1114274685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 EAST MAIN STREET",
            "city": "TALENT",
            "state": "OR",
            "postal_code": "97540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7676 ADAMS RD",
            "city": "TALENT",
            "state": "OR",
            "postal_code": "975407839",
            "telephone_number": "541-535-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KALESH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "16981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Talent, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.