Active NPI
Kerstin Staley
- Massage Therapist
- Moscow, ID
National Provider Identifier
1740064914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS-5023
- Practice address
- 116 E 3Rd St
Moscow, ID 83843-4318 - Phone
- (208) 610-3591
- NPI assigned
- Aug 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | MAS-5023 | ID | Primary |
Addresses
Primary practice location
116 E 3Rd St
Moscow, ID 83843-4318
Mailing address
PO Box 2
Uniontown, WA 99179-0002
Phone (208) 669-0039
Other practice location 1
316 N Main St
Moscow, ID 83843-2629
Phone (208) 669-0039
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 |
|---|---|---|---|
| MAS-5023 | ID | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roots Massage & Bodywork LLC Suzanne Kaplan Col MBR | Massage Therapist | Past | 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 and National Provider Directory roles.
-
- Massage Therapist
- Moscow, ID
- NPI 1225767791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1740064914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2",
"city": "UNIONTOWN",
"state": "WA",
"postal_code": "991790002",
"telephone_number": "208-669-0039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 E 3RD ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838434318",
"telephone_number": "208-610-3591"
}
],
"practiceLocations": [
{
"address_1": "316 N Main St",
"address_purpose": "LOCATION",
"city": "Moscow",
"state": "ID",
"postal_code": "838432629",
"country_code": "US",
"telephone_number": "208-669-0039",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STALEY",
"first_name": "KERSTIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-21",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MAS-5023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.