Individual provider Active NPI

Trenton Kershner, LMT

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1154898385
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
24076 Issued in OR
Practice address
155 SW Century Dr Ste 110
Bend, OR 97702-1657
Phone
(541) 788-8927
NPI assigned
Oct 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 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 24076 OR Primary

Addresses

Primary practice location

155 SW Century Dr Ste 110
Bend, OR 97702-1657

Mailing address

61055 Borden Dr
Bend, OR 97702-3021
Phone (541) 788-8927

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
24076ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1154898385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61055 BORDEN DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023021",
            "telephone_number": "541-788-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 SW CENTURY DR STE 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021657",
            "telephone_number": "541-788-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHNER",
        "first_name": "TRENTON",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.