Active NPI
Dawn Michelle Kelley, CMT
- Massage Therapist
- Fort Wayne, IN
National Provider Identifier
1376070276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT20902231
- Practice address
- 6215 Covington Rd
Fort Wayne, IN 46804-7311 - Phone
- (260) 755-5953
- Fax
- (260) 755-5956
- NPI assigned
- May 23, 2017
- Sex
- Female
- Sole proprietor
- No
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 | MT20902231 | IN | Primary |
Addresses
Primary practice location
6215 Covington Rd
Fort Wayne, IN 46804-7311
Mailing address
3222 Wakashan PL
Fort Wayne, IN 46815-6476
Phone (260) 579-1037
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT20902231 | IN | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HB Health, 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 and National Provider Directory roles.
-
- Chiropractor
- Fort Wayne, IN
- NPI 1700181039
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495497600000",
"number": "1376070276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3222 WAKASHAN PL",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468156476",
"telephone_number": "260-579-1037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6215 COVINGTON RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047311",
"telephone_number": "260-755-5953",
"fax_number": "260-755-5956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "DAWN",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "CMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-23",
"last_updated": "2017-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IN",
"license": "MT20902231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.