Keri Lee Johnson, LMT

Individual provider Active NPI Massage Therapist · Deadwood, SD

NPI 1285215285 · NPPES record last updated Feb 21, 2022

Key facts

NPI
1285215285
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT10410 (SD)
Practice address
802 Main St
Deadwood, SD 57732-1004
Phone
(605) 722-1396
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT10410SDMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stress Relief Massage & Spa LLC Massage Therapist Current
since Apr 25, 2021
Accepting new patients

Locations

802 Main St
Deadwood, SD 57732
Phone (605) 722-1396

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT10410 SD Yes

Addresses

Primary practice location

802 Main St
Deadwood, SD 57732-1004

Mailing address

802 Main St
Deadwood, SD 57732-1004
Phone (605) 722-1396

Other providers in Deadwood, SD

All providers in Deadwood, SD · Massage Therapist in South Dakota

Sources for this page

Verify at the official NPI Registry.