Individual provider Active NPI

Carrie Lynn Anderson, LMT

  • Massage Therapist
  • Grand Forks, ND
National Provider Identifier
1396287629
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
1602 Issued in ND
Practice address
1726 S Washington St Ste 79
Grand Forks, ND 58201-6370
Phone
(701) 738-0990
NPI assigned
Nov 17, 2016
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 1602 ND Primary

Addresses

Primary practice location

1726 S Washington St Ste 79
Grand Forks, ND 58201-6370

Mailing address

1395 S Columbia Rd
Suite a, Box 245
Grand Forks, ND 58201-4054
Phone (701) 330-9359

Other practice location 1

45 1st Ave SE
Mayville, ND 58257-1404
Phone (701) 786-4024

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
1602NDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Renewed Hope Chiropractic, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396287629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 S COLUMBIA RD",
            "address_2": "SUITE A, BOX 245",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014054",
            "telephone_number": "701-330-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 S WASHINGTON ST STE 79",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016370",
            "telephone_number": "701-738-0990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 1st Ave SE",
            "address_purpose": "LOCATION",
            "city": "Mayville",
            "state": "ND",
            "postal_code": "582571404",
            "country_code": "US",
            "telephone_number": "701-786-4024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ND",
            "license": "1602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.