Active NPI
Keyona Mattson, LMT
- Massage Therapist
- Wasilla, AK
National Provider Identifier
1194468942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 188621
- Practice address
- 546 N Main St
Wasilla, AK 99654-7019 - Phone
- (907) 376-2600
- NPI assigned
- Apr 19, 2022
- 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 | 188621 | AK | Primary |
Addresses
Primary practice location
546 N Main St
Wasilla, AK 99654-7019
Mailing address
PO Box 298056
Wasilla, AK 99629-8056
Phone (907) 903-3399
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 |
|---|---|---|---|
| 188621 | AK | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stanley Health Clinics PC | Current | Accepting new patients | |
| Mat-Su Chiropractic LLC | Massage Therapist | Past | Accepting new patients |
Locations
546 N Main St
Wasilla, AK 99654
Phone (907) 376-2600
Organizations & group practices 2
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.
-
- Chiropractor
- Wasilla, AK
- NPI 1891828786
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1194468942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 298056",
"city": "WASILLA",
"state": "AK",
"postal_code": "996298056",
"telephone_number": "907-903-3399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "546 N MAIN ST",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547019",
"telephone_number": "907-376-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTSON",
"first_name": "KEYONA",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-19",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AK",
"license": "188621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.