Active NPI
Kristen Anne Long, LMT
- Massage Therapist
- Mashpee, MA
National Provider Identifier
1639643992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12120
- Practice address
- 680 Falmouth Rd Ste H
Mashpee, MA 02649-3338 - Phone
- (774) 368-0863
- NPI assigned
- Jan 18, 2019
- 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 | 12120 | MA | Primary |
Addresses
Primary practice location
680 Falmouth Rd Ste H
Mashpee, MA 02649-3338
Mailing address
12 Holt Rd Apt 2
Buzzards Bay, MA 02532-3468
Phone (774) 368-0863
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 |
|---|---|---|---|
| 12120 | MA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547769600000",
"number": "1639643992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 HOLT RD APT 2",
"city": "BUZZARDS BAY",
"state": "MA",
"postal_code": "025323468",
"telephone_number": "774-368-0863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 FALMOUTH RD STE H",
"city": "MASHPEE",
"state": "MA",
"postal_code": "026493338",
"telephone_number": "774-368-0863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "KRISTEN",
"middle_name": "ANNE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-18",
"last_updated": "2019-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MA",
"license": "12120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mashpee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.