Individual provider Active NPI

Ruthanne Kerr

  • Massage Therapist
  • Wasilla, AK
National Provider Identifier
1154770444
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
111157 Issued in AK
Practice address
1261 S Seward Meridian Pkwy
Suite F
Wasilla, AK 99654-8372
Phone
(907) 357-6100
Fax
(907) 357-6102
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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 111157 AK Primary

Addresses

Primary practice location

1261 S Seward Meridian Pkwy
Suite F
Wasilla, AK 99654-8372

Mailing address

1261 S Seward Meridian Pkwy
Suite F
Wasilla, AK 99654-8372
Phone (907) 357-6100

Other names 1

  • Ruthanne Clifford Former name

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
111157AKMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1154770444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 S SEWARD MERIDIAN PKWY",
            "address_2": "SUITE F",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548372",
            "telephone_number": "907-357-6100",
            "fax_number": "907-357-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S SEWARD MERIDIAN PKWY",
            "address_2": "SUITE F",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548372",
            "telephone_number": "907-357-6100",
            "fax_number": "907-357-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "RUTHANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "111157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUTHANNE",
            "last_name": "CLIFFORD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.