Individual provider Active NPI

Brett Kingsbury, L.M.T

  • Massage Therapist
  • Grand Junction, CO
National Provider Identifier
1578960183
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0017103 Issued in CO
Practice address
2500 Broadway Unit E
Grand Junction, CO 81507-2767
Phone
(970) 644-5255
Fax
(970) 283-3230
NPI assigned
Nov 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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 0017103 CO Primary

Addresses

Primary practice location

2500 Broadway Unit E
Grand Junction, CO 81507-2767

Mailing address

514 28 1/4 Rd
Suite 4
Grand Junction, CO 81501-4961
Phone (970) 644-5255

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
0017103COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body Therapeutics, LLC Massage Therapist CurrentSince Sep 28, 2021 Accepting new patients

Locations

2500 Broadway
Unit E
Grand Junction, CO 81507
Phone (970) 343-0822

514 28 Rd
Ste 4
Grand Junction, CO 81501
Phone (970) 644-5255

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": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1578960183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 28 1/4 RD",
            "address_2": "SUITE 4",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815014961",
            "telephone_number": "970-644-5255",
            "fax_number": "970-283-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BROADWAY UNIT E",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815072767",
            "telephone_number": "970-644-5255",
            "fax_number": "970-283-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSBURY",
        "first_name": "BRETT",
        "credential": "L.M.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-25",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "0017103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.