Active NPI
Mary Katherine Riseman, CMT
- Massage Therapist
- El Dorado Hills, CA
National Provider Identifier
1609481324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 72850
- Practice address
- 5151 Golden Foothill Pkwy Ste 100
El Dorado Hills, CA 95762-9630 - Phone
- (530) 306-5170
- NPI assigned
- Sep 10, 2020
- Last updated
- Aug 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 72850 | CA | Primary |
Addresses
Primary practice location
5151 Golden Foothill Pkwy Ste 100
El Dorado Hills, CA 95762-9630
Mailing address
2200 Valley View Pkwy Apt 4121
El Dorado Hills, CA 95762-5587
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72850 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1609481324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 VALLEY VIEW PKWY APT 4121",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957625587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5151 GOLDEN FOOTHILL PKWY STE 100",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629630",
"telephone_number": "530-306-5170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISEMAN",
"first_name": "MARY",
"middle_name": "KATHERINE",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-10",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "72850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.