Individual provider Active NPI

Kathleen Vincent, LMT

  • Massage Therapist
  • Flushing, NY
National Provider Identifier
1295998342
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
017083-1 Issued in NY
Practice address
4266 Phlox PL
F11
Flushing, NY 11355-2139
Phone
(917) 662-0878
Fax
(718) 353-5815
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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 017083-1 NY Primary

Addresses

Primary practice location

4266 Phlox PL
F11
Flushing, NY 11355-2139

Mailing address

4266 Phlox PL
F11
Flushing, NY 11355-2139
Phone (917) 662-0878

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
017083-1NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1295998342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 PHLOX PL",
            "address_2": "F11",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552139",
            "telephone_number": "917-662-0878",
            "fax_number": "718-353-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 PHLOX PL",
            "address_2": "F11",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552139",
            "telephone_number": "917-662-0878",
            "fax_number": "718-353-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "KATHLEEN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "017083-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.