Individual provider Active NPI

Crystal Hicks-Parker

  • Massage Therapist
  • Holland, MI
National Provider Identifier
1487068516
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00018204 Issued in WA
Practice address
336 W 16TH St
Holland, MI 49423-3418
Phone
(425) 418-7425
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X MA00018204 WA
Massage Therapist 225700000X MA00018204 WA Primary

Addresses

Primary practice location

336 W 16TH St
Holland, MI 49423-3418

Mailing address

336 W 16TH St
Holland, MI 49423-3418
Phone (425) 418-7425

Other practice location 1

1230 NE Hickman Ct
Pullman, WA 99163-5617
Phone (509) 432-5053

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
MA00018204WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Art of Medicine PLLC 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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1487068516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W 16TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233418",
            "telephone_number": "425-418-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 W 16TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233418",
            "telephone_number": "425-418-7425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 NE Hickman Ct",
            "address_purpose": "LOCATION",
            "city": "Pullman",
            "state": "WA",
            "postal_code": "991635617",
            "country_code": "US",
            "telephone_number": "509-432-5053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS-PARKER",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "WA",
            "license": "MA00018204",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00018204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.