Active NPI
Pamela Jeanette Fraser
- Massage Therapist
- Austin, TX
National Provider Identifier
1417469685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT119246
- Practice address
- 14028 N Hwy 183 Ste D120
Austin, TX 78717-5992 - Phone
- (512) 250-8800
- Fax
- (512) 250-8800
- NPI assigned
- Oct 27, 2017
- 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 | MT119246 | TX | Primary |
Addresses
Primary practice location
14028 N Hwy 183 Ste D120
Austin, TX 78717-5992
Mailing address
106 Louise St
Elgin, TX 78621-1208
Phone (406) 599-9190
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 |
|---|---|---|---|
| MT119246 | TX | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nextgenm3 Enterpises Inc | Single Specialty | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509062400000",
"number": "1417469685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LOUISE ST",
"city": "ELGIN",
"state": "TX",
"postal_code": "786211208",
"telephone_number": "406-599-9190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14028 N HWY 183 STE D120",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787175992",
"telephone_number": "512-250-8800",
"fax_number": "512-250-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRASER",
"first_name": "PAMELA",
"middle_name": "JEANETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-27",
"last_updated": "2017-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT119246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.