Individual provider Active NPI

Jetta Kaune, LMT

  • Massage Therapist
  • Radcliff, KY
National Provider Identifier
1114587862
Registry record updated Jun 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
239911 Issued in KY
Practice address
647 Knox Blvd
Radcliff, KY 40160-1514
Phone
(270) 351-5055
NPI assigned
Jun 15, 2019
Last updated
Jun 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2019

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 239911 KY Primary

Addresses

Primary practice location

647 Knox Blvd
Radcliff, KY 40160-1514

Mailing address

1420A 4TH Ave
Fort Knox, KY 40121-2294
Phone (913) 702-2282

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
239911KYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1560556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560556800000",
    "number": "1114587862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420A 4TH AVE",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401212294",
            "telephone_number": "913-702-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 KNOX BLVD",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401601514",
            "telephone_number": "270-351-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUNE",
        "first_name": "JETTA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-15",
        "last_updated": "2019-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "239911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Radcliff, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2019; 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.