Individual provider Active NPI

Charlotte Renee Anderson, L.M.T.

  • Massage Therapist
  • Harrodsburg, KY
National Provider Identifier
1467599829
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
KY1270 Issued in KY
Practice address
584 N College St
Harrodsburg, KY 40330-2401
Phone
(859) 734-9992
Fax
(859) 734-9929
NPI assigned
Feb 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 KY1270 KY Primary

Addresses

Primary practice location

584 N College St
Harrodsburg, KY 40330-2401

Mailing address

190 Daisy St # a
Harrodsburg, KY 40330-8687
Phone (859) 325-0247

Other identifiers 1

IdentifierTypeStateIssuer
43354200OtherKYNCBTMB

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
KY1270KYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harrodsburg Chiropractic, P.S.C. 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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467599829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 DAISY ST # A",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "403308687",
            "telephone_number": "859-325-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 N COLLEGE ST",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "403302401",
            "telephone_number": "859-734-9992",
            "fax_number": "859-734-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHARLOTTE",
        "middle_name": "RENEE",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "KY1270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBTMB",
            "identifier": "43354200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrodsburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.