Kimberly Dawn Merrell

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

25425 Issued in OR

Practice address

4356 Commercial St SE
Salem, OR 97302-3914

Phone

(503) 689-1216

NPI assigned

Sep 25, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Willamette Valley Wellness LLC

  • Chiropractor
  • Salem, OR
  • NPI 1194069450

  Massage Therapist

  NPD

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1427665249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1197 SW LINDEN LN",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973389042",
            "telephone_number": "971-239-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4356 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973023914",
            "telephone_number": "503-689-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "25425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.willamettevalleywellness.com",
            "affiliation": "N",
            "endpointDescription": "Employer website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4356 Commercial St SE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973023914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stanlee Menniti
• Guadalupe Mercado
• Nancy J Mercer, RN
• Stephen James Mercer, DDS
• Victoria Meredith, CADC I
• Makenna Ann Merriss
• Cody Wayne Merritt
• Krista Kay Merrow, RDH
• Andrea P Merryman
• Kisca Kay Merryman, QMHA-R

• Massage Therapist in Salem, OR
• Providers in Salem, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.