Active NPI
Kathryn Cunnagin, LMT
- Massage Therapist
- Bend, OR
National Provider Identifier
1184162802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 22410
- Practice address
- 335 NE 4TH St
Bend, OR 97701-5162 - Phone
- (541) 668-7506
- NPI assigned
- Feb 1, 2017
- Last updated
- Dec 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 22410 | OR | Primary |
Addresses
Primary practice location
335 NE 4TH St
Bend, OR 97701-5162
Mailing address
PO Box 8074
Bend, OR 97708-8074
Phone (206) 948-0608
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22410 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Team Ward LLC | Massage Therapist | Current | Accepting new patients |
Locations
335 NE 4th St
Bend, OR 97701
Phone (541) 350-7691
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": "1485907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575417600000",
"number": "1184162802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8074",
"city": "BEND",
"state": "OR",
"postal_code": "977088074",
"telephone_number": "206-948-0608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 NE 4TH ST",
"city": "BEND",
"state": "OR",
"postal_code": "977015162",
"telephone_number": "541-668-7506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUNNAGIN",
"first_name": "KATHRYN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-01",
"last_updated": "2019-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "22410",
"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 Dec 4, 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.