Individual provider Active NPI

Caitlin Elizabeth Staley

  • Massage Therapist
  • Medford, OR
National Provider Identifier
1326564782
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
023555 Issued in OR
Practice address
310 Crater Lake Ave Ste 102
Medford, OR 97504-6857
Phone
(541) 210-5674
NPI assigned
Aug 17, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 023555 OR Primary

Addresses

Primary practice location

310 Crater Lake Ave Ste 102
Medford, OR 97504-6857

Mailing address

8026 Division Rd
White City, OR 97503-1153
Phone (541) 390-6242

Other practice location 1

8026 Division RD
White City, OR 97503
Phone (541) 390-6242

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
023555ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alevia Physical Therapy LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326564782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8026 DIVISION RD",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975031153",
            "telephone_number": "541-390-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CRATER LAKE AVE STE 102",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046857",
            "telephone_number": "541-210-5674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8026 Division RD",
            "address_purpose": "LOCATION",
            "city": "White City",
            "state": "OR",
            "postal_code": "97503",
            "country_code": "US",
            "telephone_number": "541-390-6242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALEY",
        "first_name": "CAITLIN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "023555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.