Individual provider Active NPI

Kelly Ann Myers

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1346860129
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
24363 Issued in OR
Practice address
598 NW Hill St Ste B
Bend, OR 97703-2970
Phone
(541) 639-5389
NPI assigned
Apr 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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 24363 OR Primary

Addresses

Primary practice location

598 NW Hill St Ste B
Bend, OR 97703-2970

Mailing address

598 NW Hill St Ste B
Bend, OR 97703-2970
Phone (541) 350-8067

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
24363ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holbrook Enterprise Inc. CurrentSince Apr 26, 2020 Accepting new patients
Jennifer Finley L.Ac. CurrentSince Dec 28, 2022 Accepting new patients

Locations

598 NW Hill St
Ste B
Bend, OR 97703
Phone (541) 385-7688

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1346860129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 NW HILL ST STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032970",
            "telephone_number": "541-350-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 NW HILL ST STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032970",
            "telephone_number": "541-639-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.