Individual provider Active NPI

Kiley Elizabeth Connor

  • Massage Therapist
  • Aberdeen, SD
National Provider Identifier
1386370617
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT11611 Issued in SD
Practice address
701 N 4TH St Ste 1
Aberdeen, SD 57401-2727
Phone
(605) 377-5930
NPI assigned
Jul 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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 MT11611 SD Primary

Addresses

Primary practice location

701 N 4TH St Ste 1
Aberdeen, SD 57401-2727

Mailing address

701 N 4TH St Ste 1
Aberdeen, SD 57401-2727
Phone (605) 377-5930

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
MT11611SDMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Kimball LLC Massage Therapist CurrentSince Nov 6, 2022 Accepting new patients

Locations

701 N 4th St
Ste 1
Aberdeen, SD 57401
Phone (605) 377-5930

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.

NPI Registry JSON

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1386370617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 4TH ST STE 1",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574012727",
            "telephone_number": "605-377-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 4TH ST STE 1",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574012727",
            "telephone_number": "605-377-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "KILEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SD",
            "license": "MT11611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.