Candace Petty, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

260219 Issued in KY

Practice address

546 Park St Ste 200
Bowling Green, KY 42101-1780

Phone

(270) 745-9399

NPI assigned

Jun 4, 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.

• Integrative Body Therapeutics

  • Massage Therapist
  • Bowling Green, KY
  • NPI 1982051926
  NPD (past)

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1699399600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 VINING CT",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 PARK ST STE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011780",
            "telephone_number": "270-745-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "CANDACE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "260219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Nicole Peter
• Jonathan Peters, LCSW
• Rachael Peters
• Anne Taylor Peterson, LPA
• Jacqueline Peterson, M.A.E.
• Hannah Jo Peveler
• William Pfohl, PSYD
• Heather Phelps
• Stacy Rebecca Phelps, M.S. CCC-SLP
• Tracey Lynn Phelps

• Massage Therapist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Massage Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.