Individual provider Active NPI

Steven Bennett, LMT

  • Massage Therapist
  • Ketchikan, AK
National Provider Identifier
1164006169
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
164947 Issued in AK
Practice address
2050 Sea Level Dr Ste 106
Ketchikan, AK 99901-6058
Phone
(907) 225-7246
NPI assigned
May 6, 2021
Last updated
May 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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 164947 AK Primary

Addresses

Primary practice location

2050 Sea Level Dr Ste 106
Ketchikan, AK 99901-6058

Mailing address

2050 Sea Level Dr Ste 106
Ketchikan, AK 99901-6058
Phone (907) 225-7246

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
164947AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Chiropractic and Physical Medicine Ketchikan CurrentSince May 9, 2021 Accepting new patients

Locations

2050 Sea Level Dr
Ste 106
Ketchikan, AK 99901
Phone (877) 803-8297

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1164006169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 SEA LEVEL DR STE 106",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016058",
            "telephone_number": "907-225-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 SEA LEVEL DR STE 106",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016058",
            "telephone_number": "907-225-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "STEVEN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "164947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.