Individual provider Active NPI

Heather L Archer, L.M.T.

  • Massage Therapist
  • Brick, NJ
National Provider Identifier
1306288782
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18KT00530800 Issued in NJ
Practice address
11 Princeton Ave
Brick, NJ 08724-3562
Phone
(908) 814-1690
Fax
(732) 557-0259
NPI assigned
Jul 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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 18KT00530800 NJ Primary

Addresses

Primary practice location

11 Princeton Ave
Brick, NJ 08724-3562

Mailing address

1052 Halliard Ave
Beachwood, NJ 08722-2317
Phone (908) 814-1690

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
18KT00530800NJMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1306288782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1052 HALLIARD AVE",
            "city": "BEACHWOOD",
            "state": "NJ",
            "postal_code": "087222317",
            "telephone_number": "908-814-1690",
            "fax_number": "732-557-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PRINCETON AVE",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243562",
            "telephone_number": "908-814-1690",
            "fax_number": "732-557-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT00530800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.