Active NPI
Krystle Fawn Anderson
- Massage Therapist
- Brookfield, WI
National Provider Identifier
1225713472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 17040 W Greenfield Ave Ste 6
Brookfield, WI 53005-6844 - Phone
- (262) 439-8019
- NPI assigned
- Jun 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | WI | Primary |
Addresses
Primary practice location
17040 W Greenfield Ave Ste 6
Brookfield, WI 53005-6844
Mailing address
2467 S Burrell St Apt 3
Milwaukee, WI 53207-1562
Phone (414) 627-6668
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NSK Precision Healing and Wellness LLC | Single Specialty | 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": "1686787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1225713472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2467 S BURRELL ST APT 3",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532071562",
"telephone_number": "414-627-6668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17040 W GREENFIELD AVE STE 6",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530056844",
"telephone_number": "262-439-8019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KRYSTLE",
"middle_name": "FAWN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-15",
"last_updated": "2023-06-15",
"certification_date": "2023-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.