Individual provider Active NPI

Amanda Jean Kohler, LMT

  • Massage Therapist
  • Elyria, OH
National Provider Identifier
1174961601
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
33.019279 Issued in OH
Practice address
884 Hartford Dr
Elyria, OH 44035-3006
Phone
(440) 654-3400
Fax
(440) 731-8809
NPI assigned
Jun 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X
Massage Therapist 225700000X 33.019279 OH Primary

Addresses

Primary practice location

884 Hartford Dr
Elyria, OH 44035-3006

Mailing address

884 Hartford Dr
Elyria, OH 44035-3006
Phone (440) 654-3400

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
33.019279OHMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1174961601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 HARTFORD DR",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440353006",
            "telephone_number": "440-654-3400",
            "fax_number": "440-731-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 HARTFORD DR",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440353006",
            "telephone_number": "440-654-3400",
            "fax_number": "440-731-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.019279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.