Individual provider Active NPI

Nicole Rogers, LMT

  • Massage Therapist
  • Anchorage, AK
National Provider Identifier
1235860362
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
175397 Issued in AK
Practice address
1350 W Northern Lights Blvd Ste C
Anchorage, AK 99503-3614
Phone
(907) 334-8020
NPI assigned
Jun 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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 175397 AK Primary

Addresses

Primary practice location

1350 W Northern Lights Blvd Ste C
Anchorage, AK 99503-3614

Mailing address

1350 W Northern Lights Blvd Ste C
Anchorage, AK 99503-3614
Phone (907) 334-8020

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
175397AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Khrista Fortune Massage Therapist CurrentSince Jan 15, 2023 Accepting new patients

Locations

1350 W Northern Lights Blvd
Ste C
Anchorage, AK 99503
Phone (907) 334-8020

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": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1235860362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W NORTHERN LIGHTS BLVD STE C",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033614",
            "telephone_number": "907-334-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W NORTHERN LIGHTS BLVD STE C",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033614",
            "telephone_number": "907-334-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "NICOLE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "175397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.

Verify at the official NPI Registry.