Active NPI
Kelly Christine Gill, LMT
- Massage Therapist
- Los Alamos, NM
National Provider Identifier
1194301283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 5728
- Practice address
- 3500 Trinity Dr Ste C5
Los Alamos, NM 87544-2221 - Phone
- (505) 413-4061
- NPI assigned
- Mar 20, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 5728 | NM | Primary |
Addresses
Primary practice location
3500 Trinity Dr Ste C5
Los Alamos, NM 87544-2221
Mailing address
118 Aztec Ave
White Rock, NM 87547-3405
Phone (505) 413-0632
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 |
|---|---|---|---|
| 5728 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616198400000",
"number": "1194301283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 AZTEC AVE",
"city": "WHITE ROCK",
"state": "NM",
"postal_code": "875473405",
"telephone_number": "505-413-0632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 TRINITY DR STE C5",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875442221",
"telephone_number": "505-413-4061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILL",
"first_name": "KELLY",
"middle_name": "CHRISTINE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-20",
"last_updated": "2021-03-20",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "5728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.