Individual provider Active NPI

Andrea Danette Palmer, CMT LMT

  • Massage Therapist
  • Wheat Ridge, CO
National Provider Identifier
1114275138
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
13183 Issued in CO
Practice address
4304 Kipling St
B
Wheat Ridge, CO 80033-6818
Phone
(303) 906-0875
NPI assigned
Aug 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 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 13183 CO Primary

Addresses

Primary practice location

4304 Kipling St
B
Wheat Ridge, CO 80033-6818

Mailing address

11860 W 32ND Ave
Wheat Ridge, CO 80033-6507
Phone (303) 906-0875

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
13183COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1345680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1114275138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11860 W 32ND AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336507",
            "telephone_number": "303-906-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 KIPLING ST",
            "address_2": "B",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336818",
            "telephone_number": "303-906-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "ANDREA",
        "middle_name": "DANETTE",
        "credential": "CMT LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-23",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "13183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.