Kristin Allie Costello, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

12922-146 Issued in WI

Practice address

S31W24757 W Sunset Dr
Waukesha, WI 53189-7014

Phone

(262) 547-2250

Fax

(262) 547-2775

NPI assigned

Sep 9, 2020

Sex

Female

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 and National Provider Directory roles.

• Badger Health Center SC

  • Chiropractor
  • Waukesha, WI
  • NPI 1144419714
  NPD

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1659986453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 MAPLE WAY S",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883911",
            "telephone_number": "262-894-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S31W24757 W SUNSET DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897014",
            "telephone_number": "262-547-2250",
            "fax_number": "262-547-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "KRISTIN",
        "middle_name": "ALLIE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "12922-146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cork Medical LLC
• Tracey Cornella-Carlson, MD
• Cornerstone Caregiving East LLC
• Cornerstone Counseling Services
• Jean C Cortez, LPC
• Tracy R. Coulter, D.P.M.
• Kristin E Courchaine, R.PH.
• Amanda Courtney
• Norah Julie Cowley
• Nicole Craig

• Massage Therapist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Massage Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.