Krista Derosa

Primary specialty

Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X

License

006291 Issued in CT

Practice address

590 Middlebury Rd
Middlebury, CT 06762-2562

Phone

(860) 866-7115

NPI assigned

Jan 13, 2016

Last updated

Jan 13, 2016By 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

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1245696798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 FRONT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574464",
            "telephone_number": "860-866-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 MIDDLEBURY RD",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622562",
            "telephone_number": "860-866-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSA",
        "first_name": "KRISTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "128313",
            "primary": false
        },
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "CT",
            "license": "006291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loreen Richard Daigle, D.C.
• Michael Andrew Dane, PT
• Joseph P Deluca, M.D.
• Alex Ralph Demac, M.D.
• Joseph Daniel Demayo, M.D.
• Nadia Desimone, SLP
• Maureen A Devlin, RD
• Ayan Mohamed Dirir, LPC, LCPC
• Dr Mandava DDS Family Dentistry PC
• Grace Duke, SLP

• Nurse Massage Therapist (NMT) in Middlebury, CT
• Providers in Middlebury, CT by specialty
• Nurse Massage Therapist (NMT) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.