Active NPI
Kristi Stevens
- Massage Therapist
- Kissimmee, FL
National Provider Identifier
1265088231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA57887
- Practice address
- 394 Village Dr
Kissimmee, FL 34759-4009 - Phone
- (407) 914-9168
- Fax
- (863) 496-4456
- NPI assigned
- Aug 14, 2019
- Sex
- Female
- Sole proprietor
- No
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 | MA57887 | FL | Primary |
Addresses
Primary practice location
394 Village Dr
Kissimmee, FL 34759-4009
Mailing address
2717 Eagle Canyon Dr S
Kissimmee, FL 34746-3170
Phone (407) 914-9168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101583100 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA57887 | FL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C3 Wellness, LLC | Massage Therapist | 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": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565740800000",
"number": "1265088231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2717 EAGLE CANYON DR S",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347463170",
"telephone_number": "407-914-9168",
"fax_number": "863-496-4456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "394 VILLAGE DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347594009",
"telephone_number": "407-914-9168",
"fax_number": "863-496-4456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "KRISTI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-14",
"last_updated": "2019-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA57887",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101583100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.