Misty C Keeler, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAS-3758 Issued in ID

Practice address

4061 Idewild Loop Unit 306
Coeur D Alene, ID 83814-7094

Phone

(208) 620-0931

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Misty Sellars Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1568020451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4061 IDEWILD LOOP UNIT 306",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838147094",
            "telephone_number": "208-699-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 IDEWILD LOOP UNIT 306",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838147094",
            "telephone_number": "208-620-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELER",
        "first_name": "MISTY",
        "middle_name": "C",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS-3758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "MAS-3758",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "SELLARS",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jackie Lyn Kayne-Sherar, PEER SUPPORT
• Vanessa Kazemba
• Jennifer Keane, LPC
• Collin Ross Keating, LSWAIC, MHP, CPC
• Cyndi Keck
• Warren C Keene, MD
• Natalie Anne Keese-Hamm, LMFT3073
• Connie Keibler, ARNP
• Carly Nicole Kein, DO
• Erica Sande Kellenbeck, MD

• Massage Therapist in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.