Individual provider Active NPI

Anne C Tegtmeier, LMT

  • Lactation Consultant (Non-RN)
  • Portland, OR
National Provider Identifier
1184992810
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
Practice address
12349 SE Knapp St
Portland, OR 97236-5017
Phone
(860) 922-6439
NPI assigned
Dec 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X Primary
Massage Therapist 225700000X 18614 OR

Addresses

Primary practice location

12349 SE Knapp St
Portland, OR 97236-5017

Mailing address

12349 SE Knapp St
Portland, OR 97236-5017
Phone (860) 922-6439

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
18614ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mamahaven Massage Past Accepting new patients

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": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1184992810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12349 SE KNAPP ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972365017",
            "telephone_number": "860-922-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12349 SE KNAPP ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972365017",
            "telephone_number": "860-922-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGTMEIER",
        "first_name": "ANNE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "18614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.