Hannah Camilla Nusbaum, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

121821 Issued in AK

Practice address

43335 Kalifornsky Beach Rd Ste 25
Soldotna, AK 99669-8280

Phone

(907) 394-8345

Fax

(907) 283-5350

NPI assigned

Nov 1, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jade Vine Massage

  • Massage Therapist
  • Soldotna, AK
  • NPI 1407368293

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1316459100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 COURTNEY DR",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116646",
            "telephone_number": "907-394-8345",
            "fax_number": "907-283-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43335 KALIFORNSKY BEACH RD STE 25",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698280",
            "telephone_number": "907-394-8345",
            "fax_number": "907-283-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSBAUM",
        "first_name": "HANNAH",
        "middle_name": "CAMILLA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "121821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Lighthouse Dba Northern Lighthouse Day Center
• Northern Nursing Services, Inc.
• Northern Orthopedics Inc
• Northern Psychology Resources LLC
• Colleen Nusbaum, LCSW, CDCI
• Daniel D Nyitrai, PA-C
• Jonathan Michael O'Brien
• Eric Clifford O'Guinn, CPO
• Vidya H. Oftedal, SLP
• Marcus E Olsen

• Massage Therapist in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.