Individual provider Active NPI

Amelia Louise Staffeldt, LMT

  • Massage Therapist
  • Sussex, WI
National Provider Identifier
1568194702
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
12778 Issued in WI
Practice address
N64W24050 Main St Ste 306B
Sussex, WI 53089-3000
Phone
(262) 200-1205
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 12778-146 WI
Massage Therapist 225700000X 12778 WI Primary

Addresses

Primary practice location

N64W24050 Main St Ste 306B
Sussex, WI 53089-3000

Mailing address

N64W24050 Main St Ste 306B
Sussex, WI 53089-3000
Phone (262) 200-1205

Other practice location 1

17040 W Greenfield Ave Ste 6
Brookfield, WI 53005-6844
Phone (262) 439-8019

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
12778WIMDMassage Therapist
12778-146WIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Wellness LLC Massage Therapist CurrentSince Jan 12, 2025 Accepting new patients

Locations

N64W24050 Main St
Ste 306B
Sussex, WI 53089
Phone (262) 200-1205

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1568194702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N64W24050 MAIN ST STE 306B",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530893000",
            "telephone_number": "262-200-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N64W24050 MAIN ST STE 306B",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530893000",
            "telephone_number": "262-200-1205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17040 W Greenfield Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530056844",
            "country_code": "US",
            "telephone_number": "262-439-8019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFELDT",
        "first_name": "AMELIA",
        "middle_name": "LOUISE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "12778-146",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "12778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.