Individual provider Active NPI

Kimberly S Adams, LMT

  • Massage Therapist
  • Beavercreek, OH
National Provider Identifier
1679069306
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
17653 Issued in OH
Practice address
3060 Dayton Xenia Rd Ste C
Beavercreek, OH 45434-6393
Phone
(937) 427-2225
Fax
(937) 405-1078
NPI assigned
Jul 5, 2018
Last updated
Apr 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 17653 OH Primary

Addresses

Primary practice location

3060 Dayton Xenia Rd Ste C
Beavercreek, OH 45434-6393

Mailing address

1887 Stewart Rd
Xenia, OH 45385-9021
Phone (937) 689-7760

Other names 1

  • Kimberly S Robinson Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical & Wellness Center, Inc. Single Specialty PastSince Sep 25, 2017 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1679069306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 STEWART RD",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453859021",
            "telephone_number": "937-689-7760",
            "fax_number": "937-405-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 DAYTON XENIA RD STE C",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346393",
            "telephone_number": "937-427-2225",
            "fax_number": "937-405-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "17653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "ROBINSON",
            "middle_name": "S",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.

Verify at the official NPI Registry.