Individual provider Active NPI

Kelley Fifarek, LMT

  • Massage Therapist
  • Traverse City, MI
National Provider Identifier
1245143650
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501007938 Issued in MI
Practice address
827 W Front St
Traverse City, MI 49684-2465
Phone
(231) 946-9246
Fax
(231) 946-0750
NPI assigned
Sep 25, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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 7501007938 MI Primary

Addresses

Primary practice location

827 W Front St
Traverse City, MI 49684-2465

Mailing address

827 W Front St
Traverse City, MI 49684-2465
Phone (231) 946-9246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1245143650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842465",
            "telephone_number": "231-946-9246",
            "fax_number": "231-946-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842465",
            "telephone_number": "231-946-9246",
            "fax_number": "231-946-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFAREK",
        "first_name": "KELLEY",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501007938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.