Individual provider Active NPI

Tracy JH Crawford, LMT

  • Massage Therapist
  • Bangor, ME
National Provider Identifier
1609601681
Registry record updated Jun 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT1268 Issued in ME
Practice address
277 State St Ste 1a
Bangor, ME 04401-5440
Phone
(207) 991-3996
NPI assigned
Sep 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 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
Massage Therapist 225700000X MT1268 ME Primary

Addresses

Primary practice location

277 State St Ste 1a
Bangor, ME 04401-5440

Mailing address

696 Hudson Rd
Glenburn, ME 04401-1492
Phone (207) 991-3996

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
MT1268MEMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Oak LLC Massage Therapist CurrentSince Feb 1, 2025 Accepting new patients

Locations

277 State St
Ste 1A
Bangor, ME 04401
Phone (207) 990-1615

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": "1725667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750550400000",
    "number": "1609601681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 HUDSON RD",
            "city": "GLENBURN",
            "state": "ME",
            "postal_code": "044011492",
            "telephone_number": "207-991-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 STATE ST STE 1A",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015440",
            "telephone_number": "207-991-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "TRACY",
        "middle_name": "JH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-07",
        "last_updated": "2025-06-22",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.