Active NPI
Crystal Collette Rose, LMT
- Massage Therapist
- Wasilla, AK
National Provider Identifier
1598208142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT123080
- Practice address
- 2801 E Palmer Wasilla Hwy
Suite C
Wasilla, AK 99654-7339 - Phone
- (907) 357-3577
- Fax
- (907) 357-3580
- NPI assigned
- Nov 30, 2016
- Last updated
- Nov 30, 2016
- Sex
- Female
- 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 | MT123080 | TX | Primary |
Addresses
Primary practice location
2801 E Palmer Wasilla Hwy
Suite C
Wasilla, AK 99654-7339
Mailing address
2801 E Palmer Wasilla Hwy
Suite C
Wasilla, AK 99654-7339
Phone (907) 357-3577
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 |
|---|---|---|---|
| MT123080 | TX | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grasman-Montgomery Enterprises, Inc | Past | Accepting new patients | |
| Elizabeth Keeter D.C. LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Authentic Life Chiropractic
- Chiropractor
- Wasilla, AK
- NPI 1720448079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480464000000",
"number": "1598208142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 E PALMER WASILLA HWY",
"address_2": "SUITE C",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547339",
"telephone_number": "907-357-3577",
"fax_number": "907-357-3580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 E PALMER WASILLA HWY",
"address_2": "SUITE C",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547339",
"telephone_number": "907-357-3577",
"fax_number": "907-357-3580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "CRYSTAL",
"middle_name": "COLLETTE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-30",
"last_updated": "2016-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT123080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.