Active NPI
Nicole Walters, LMT
- Massage Therapist
- Auburn, NY
National Provider Identifier
1740760107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 026401-1
- Practice address
- 1 Hoffman St
Auburn, NY 13021-2157 - Phone
- (315) 704-0319
- Fax
- (315) 728-9445
- NPI assigned
- Aug 15, 2018
- 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 | 026401-1 | NY | Primary |
Addresses
Primary practice location
1 Hoffman St
Auburn, NY 13021-2157
Mailing address
1 Hoffman St
Auburn, NY 13021-2157
Phone (315) 704-0319
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 |
|---|---|---|---|
| 026401-1 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1740760107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HOFFMAN ST",
"city": "AUBURN",
"state": "NY",
"postal_code": "130212157",
"telephone_number": "315-704-0319",
"fax_number": "315-728-9445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOFFMAN ST",
"city": "AUBURN",
"state": "NY",
"postal_code": "130212157",
"telephone_number": "315-704-0319",
"fax_number": "315-728-9445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "026401-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.