Allen Fender, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501007855 Issued in MI

Practice address

57424 Megan Dr
Washington, MI 48094-3816

Phone

(586) 255-7471

NPI assigned

Apr 16, 2021

Last updated

Apr 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• KBT Pain Management & Recovery

  • Massage Therapist
  • Washington, MI
  • NPI 1437872892
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1659952125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57424 MEGAN DR",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480943816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57424 MEGAN DR",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480943816",
            "telephone_number": "586-255-7471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19793 MacArthur",
            "address_purpose": "LOCATION",
            "city": "Redford",
            "state": "MI",
            "postal_code": "482401526",
            "country_code": "US",
            "telephone_number": "586-943-9803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENDER",
        "first_name": "ALLEN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501007855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Washington, MI
• Providers in Washington, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.