Active NPI
Melissa Kae Redfield, CMT
- Massage Therapist
- Maple Grove, MN
National Provider Identifier
1134409121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2011-63
- Practice address
- 12069 Elm Creek Blvd N
Maple Grove, MN 55369-7094 - Phone
- (952) 454-6146
- NPI assigned
- Aug 22, 2011
- Last updated
- Aug 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 2011-63 | MN | Primary |
Addresses
Primary practice location
12069 Elm Creek Blvd N
Maple Grove, MN 55369-7094
Mailing address
17019 Argon St NW
Andover, MN 55304-1600
Phone (952) 454-6146
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2011-63 | MN | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313971200000",
"number": "1134409121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17019 ARGON ST NW",
"city": "ANDOVER",
"state": "MN",
"postal_code": "553041600",
"telephone_number": "952-454-6146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12069 ELM CREEK BLVD N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553697094",
"telephone_number": "952-454-6146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDFIELD",
"first_name": "MELISSA",
"middle_name": "KAE",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-22",
"last_updated": "2011-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MN",
"license": "2011-63",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.