Active NPI
Kimberly Pruetting, LMT
- Massage Therapist
- Anchorage, AK
National Provider Identifier
1417728080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 225700000X
- Practice address
- 7731 E Northern Lights Blvd Ste 220
Anchorage, AK 99504-3572 - Phone
- (907) 280-9991
- NPI assigned
- Jan 12, 2024
- Last updated
- Jan 12, 2024
- 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 | 225700000X | AK | Primary |
Addresses
Primary practice location
7731 E Northern Lights Blvd Ste 220
Anchorage, AK 99504-3572
Mailing address
2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824
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 |
|---|---|---|---|
| 225700000X | AK | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705017600000",
"number": "1417728080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 BUTTERFIELD RD STE 301N",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231266",
"telephone_number": "630-468-1824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7731 E NORTHERN LIGHTS BLVD STE 220",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995043572",
"telephone_number": "907-280-9991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUETTING",
"first_name": "KIMBERLY",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-12",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AK",
"license": "225700000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
- Providence Health System Washington (Providence Apothecary)
- Providence Imaging Center
- Providence Imaging Center
- Providence Surgery Centers LLC (Creekside Surgical Center)
- Ellen Michelle Provost, DO
- Alexis Victoria Pruitt
- Ellen Pryor, OTRL
- Psychiatric and Addiction Recovery Center of Alaska, LLC
- Psychological Services Group, LLC
- Psychological Services Group, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.