Active NPI
Kirsten A Davis, LMP
- Massage Therapist
- Idaho Falls, ID
National Provider Identifier
1376852053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 1995 E 17TH St
Suite 2
Idaho Falls, ID 83404-6493 - Phone
- (208) 529-2352
- NPI assigned
- Sep 29, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 602981393 | WA | |
| Massage Therapist | 225700000X | ID | Primary |
Addresses
Primary practice location
1995 E 17TH St
Suite 2
Idaho Falls, ID 83404-6493
Mailing address
1995 E 17TH St
Suite 2
Idaho Falls, ID 83404-6493
Phone (208) 529-2352
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 |
|---|---|---|---|
| 602981393 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352419200000",
"number": "1376852053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1995 E 17TH ST",
"address_2": "SUITE 2",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834046493",
"telephone_number": "208-529-2352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1995 E 17TH ST",
"address_2": "SUITE 2",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834046493",
"telephone_number": "208-529-2352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KIRSTEN",
"middle_name": "A",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-29",
"last_updated": "2012-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "602981393",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.