Active NPI
Kenneth Owen Scharbach
- Massage Therapist
- Lewiston, ID
National Provider Identifier
1497992572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 00019448
- Practice address
- 3316 1/2 4TH St
Suite 4a
Lewiston, ID 83501-4460 - Phone
- (208) 798-5420
- Fax
- (208) 798-5430
- NPI assigned
- Jan 12, 2009
- Sex
- Male
- 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 | MA 00019448 | WA | Primary |
Addresses
Primary practice location
3316 1/2 4TH St
Suite 4a
Lewiston, ID 83501-4460
Mailing address
3316 1/2 4TH St
Suite 4a
Lewiston, ID 83501-4460
Phone (208) 798-5420
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 |
|---|---|---|---|
| MA 00019448 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearwater Chiropractic & Acupuncture PA | 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": "1231718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1497992572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3316 1/2 4TH ST",
"address_2": "SUITE 4A",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835014460",
"telephone_number": "208-798-5420",
"fax_number": "208-798-5430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3316 1/2 4TH ST",
"address_2": "SUITE 4A",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835014460",
"telephone_number": "208-798-5420",
"fax_number": "208-798-5430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHARBACH",
"first_name": "KENNETH",
"middle_name": "OWEN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-12",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 00019448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.