Active NPI
Keera Kimball
- Massage Therapist
- Sioux Falls, SD
National Provider Identifier
1699494690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT11866
- Practice address
- 100 N Krohn PL
Sioux Falls, SD 57103-1815 - Phone
- (605) 331-0588
- NPI assigned
- Aug 23, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT11866 | SD | Primary |
Addresses
Primary practice location
100 N Krohn PL
Sioux Falls, SD 57103-1815
Mailing address
4200 W Valhalla Blvd Apt 4
Sioux Falls, SD 57106-3715
Phone (712) 239-0424
Other names 1
- Keera Stanley
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 |
|---|---|---|---|
| MT11866 | SD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1699494690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 W VALHALLA BLVD APT 4",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571063715",
"telephone_number": "712-239-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N KROHN PL",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571031815",
"telephone_number": "605-331-0588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "KEERA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-23",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "SD",
"license": "MT11866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KEERA",
"last_name": "STANLEY",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.