Individual provider Active NPI

Kyle Stutler

  • Massage Therapist
  • Barboursville, WV
National Provider Identifier
1306680772
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2022-3984 Issued in WV
Practice address
950 Lauren Christian Dr
Barboursville, WV 25504-9346
Phone
(304) 410-0900
NPI assigned
Jun 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 2022-3984 WV Primary

Addresses

Primary practice location

950 Lauren Christian Dr
Barboursville, WV 25504-9346

Mailing address

209 19TH St Apt 6
Huntington, WV 25703-1144
Phone (304) 939-0579

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
2022-3984WVMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1306680772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 19TH ST APT 6",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031144",
            "telephone_number": "304-939-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 LAUREN CHRISTIAN DR",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255049346",
            "telephone_number": "304-410-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTLER",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "2022-3984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barboursville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.