Individual provider Active NPI

Kathryn Cunnagin, LMT

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1184162802
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
22410 Issued in OR
Practice address
335 NE 4TH St
Bend, OR 97701-5162
Phone
(541) 668-7506
NPI assigned
Feb 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 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 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

LicenseStateTypeSpecialty
22410ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Ward LLC Massage Therapist CurrentSince Jan 1, 2023 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 and National Provider Directory roles.

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.

Verify at the official NPI Registry.