Active NPI
Caroline Glover, LMT
- Massage Therapist
- Fitchburg, WI
National Provider Identifier
1679110670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 14317-146
- Practice address
- 5973 Executive Dr
Fitchburg, WI 53719-5335 - Phone
- (608) 278-8118
- NPI assigned
- Dec 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 14317 | WI | |
| Massage Therapist | 225700000X | 14317-146 | WI | Primary |
Addresses
Primary practice location
5973 Executive Dr
Fitchburg, WI 53719-5335
Mailing address
5973 Executive Dr
Fitchburg, WI 53719-5335
Phone (608) 278-8118
Other practice location 1
238 Front St
Cashton, WI 54619-2002
Phone (608) 654-5100
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 |
|---|---|---|---|
| 14317 | WI | MD | Massage Therapist |
| 14317-146 | WI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697673600000",
"number": "1679110670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5973 EXECUTIVE DR",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537195335",
"telephone_number": "608-278-8118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5973 EXECUTIVE DR",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537195335",
"telephone_number": "608-278-8118"
}
],
"practiceLocations": [
{
"address_1": "238 Front St",
"address_purpose": "LOCATION",
"city": "Cashton",
"state": "WI",
"postal_code": "546192002",
"country_code": "US",
"telephone_number": "608-654-5100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLOVER",
"first_name": "CAROLINE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-09",
"last_updated": "2023-10-19",
"certification_date": "2023-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "14317",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "14317-146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fitchburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.