Kelly Jo Emerson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAS Issued in ID

Practice address

51 Pine St
Unit G
Sandpoint, ID 83864

Phone

(208) 502-0728

NPI assigned

Dec 21, 2017

Last updated

Dec 21, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Momentum Medical Massage and Personal Training, LLC

  • Massage Therapist
  • Sandpoint, ID
  • NPI 1295388536
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1215443668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 FOREST KNOLLS DR",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838645283",
            "telephone_number": "360-909-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 PINE ST",
            "address_2": "UNIT G",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "83864",
            "telephone_number": "208-502-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": "MAS",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beaver E Eller, FNP-BC, AGACNP-BC
• Jennifer Lynn Ellison, LPC
• Mallorie Ely, LCSW
• Embodied Virtue
• Aidan Paul Emerson, LMT
• Energy Electric, Inc (North Idaho Speech Language Associates)
• Erickson PT Enterprises PLLC (Lake Country Physical Therapy)
• Angelina Espinoza
• Angela K Evans, D.C.
• Linda Evans, LMSW

• Massage Therapist in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.