Individual provider Active NPI

Krista R Hefty, LMT

  • Massage Therapist
  • Fairdale, KY
National Provider Identifier
1235775511
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
260892 Issued in KY
Practice address
10701 W Manslick Rd
Fairdale, KY 40118-9581
Phone
(502) 367-2112
Fax
(502) 367-0702
NPI assigned
Nov 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 260892 KY Primary

Addresses

Primary practice location

10701 W Manslick Rd
Fairdale, KY 40118-9581

Mailing address

148 Coral Bay CT Apt 1
Shepherdsville, KY 40165-7974
Phone (502) 751-2309

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
260892KYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1235775511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 CORAL BAY CT APT 1",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401657974",
            "telephone_number": "502-751-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 W MANSLICK RD",
            "city": "FAIRDALE",
            "state": "KY",
            "postal_code": "401189581",
            "telephone_number": "502-367-2112",
            "fax_number": "502-367-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFTY",
        "first_name": "KRISTA",
        "middle_name": "R",
        "name_prefix": "Miss",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "260892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairdale, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.