Individual provider Active NPI

Caroline Glover, LMT

  • Massage Therapist
  • Fitchburg, WI
National Provider Identifier
1679110670
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
14317-146 Issued in WI
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

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
14317WIMDMassage Therapist
14317-146WIMDMassage 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.

Verify at the official NPI Registry.