Active NPI
Kayla Shafer, MT
- Massage Therapist
- Denver, CO
National Provider Identifier
1114656196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 0021442
- Practice address
- 1575 S Decatur St
Denver, CO 80219-4735 - Phone
- (970) 749-8128
- NPI assigned
- Jun 6, 2022
- 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 | 0021442 | CO | Primary |
Addresses
Primary practice location
1575 S Decatur St
Denver, CO 80219-4735
Mailing address
2092 S Yank Way
Lakewood, CO 80228-4311
Phone (303) 253-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| O804464 | Medicaid | CO |
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
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0021442 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1114656196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2092 S YANK WAY",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802284311",
"telephone_number": "303-253-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 S DECATUR ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802194735",
"telephone_number": "970-749-8128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "KAYLA",
"credential": "MT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-06",
"last_updated": "2022-06-06",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "0021442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "O804464",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.