Individual provider Active NPI

Kristen A Humphrey, LMT

  • Massage Therapist
  • Ashland, OR
National Provider Identifier
1336658020
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
21372 Issued in OR
Practice address
258 A St Ste 21
Ashland, OR 97520-1947
Phone
(541) 301-7040
NPI assigned
Sep 25, 2017
Last updated
Sep 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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 21372 OR Primary

Addresses

Primary practice location

258 A St Ste 21
Ashland, OR 97520-1947

Mailing address

2000 Colestin Rd
Ashland, OR 97520-8726
Phone (303) 829-3055

Other names 1

  • Willow Humphrey Professional name

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
21372ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Acupuncture and Natural Health LLC Massage Therapist 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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1336658020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 COLESTIN RD",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975208726",
            "telephone_number": "303-829-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 A ST STE 21",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201947",
            "telephone_number": "541-301-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "KRISTEN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "21372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLOW",
            "last_name": "HUMPHREY",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Ashland, OR

Sources for this page

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