Active NPI
Susan Catherine Klecker
- Massage Therapist
- Stillwater, MN
National Provider Identifier
1366938300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 116 Chestnut St E
Stillwater, MN 55082-5116 - Phone
- (651) 417-1180
- NPI assigned
- Jul 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
116 Chestnut St E
Stillwater, MN 55082-5116
Mailing address
1534 Cottage Dr
Stillwater, MN 55082-5962
Phone (515) 447-3002
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530489600000",
"number": "1366938300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1534 COTTAGE DR",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550825962",
"telephone_number": "515-447-3002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 CHESTNUT ST E",
"city": "STILLWATER",
"state": "MN",
"postal_code": "550825116",
"telephone_number": "651-417-1180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLECKER",
"first_name": "SUSAN",
"middle_name": "CATHERINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-02",
"last_updated": "2018-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.