Active NPI
Kelly Marie Carpenter, CMT
- Massage Therapist
- San Jose, CA
National Provider Identifier
1437641834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 75185
- Practice address
- 2075 Lincoln Ave
San Jose, CA 95125-3513 - Phone
- (669) 235-7754
- NPI assigned
- May 31, 2018
- 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 | 75185 | CA | Primary |
Addresses
Primary practice location
2075 Lincoln Ave
San Jose, CA 95125-3513
Mailing address
PO Box 8036
San Jose, CA 95155-8036
Phone (669) 235-7754
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 |
|---|---|---|---|
| 75185 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527724800000",
"number": "1437641834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8036",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951558036",
"telephone_number": "669-235-7754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2075 LINCOLN AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951253513",
"telephone_number": "669-235-7754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "KELLY",
"middle_name": "MARIE",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-31",
"last_updated": "2018-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "75185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.