Individual provider Active NPI

Amanda L Kraeger, LMT

  • Massage Therapist
  • Lowville, NY
National Provider Identifier
1144739731
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
017562 Issued in NY
Practice address
7686 N State St
Lowville, NY 13367-1330
Phone
(315) 376-0102
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 017562 NY Primary

Addresses

Primary practice location

7686 N State St
Lowville, NY 13367-1330

Mailing address

7686 N State St
Lowville, NY 13367-1330
Phone (315) 376-0102

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
017562NYMDAddiction (Substance Use Disorder) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Wellness of Northern New York, PLLC PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144739731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7686 N STATE ST",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133671330",
            "telephone_number": "315-376-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7686 N STATE ST",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133671330",
            "telephone_number": "315-376-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAEGER",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "017562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.