Individual provider Active NPI

Kerstin S Tracy, MS, LMT

  • Massage Therapist
  • Reno, NV
National Provider Identifier
1750650529
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
5312 Issued in NV
Practice address
6135 Lakeside Dr
Suite 119
Reno, NV 89511-8504
Phone
(775) 400-0058
NPI assigned
Dec 22, 2011
Last updated
Dec 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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 5312 NV Primary
Massage Therapist 225700000X 30359 FL

Addresses

Primary practice location

6135 Lakeside Dr
Suite 119
Reno, NV 89511-8504

Mailing address

9180 Jack Hammer Dr
Reno, NV 89521-4090

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30359FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1750650529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9180 JACK HAMMER DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895214090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 LAKESIDE DR",
            "address_2": "SUITE 119",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895118504",
            "telephone_number": "775-400-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "KERSTIN",
        "middle_name": "S",
        "credential": "MS, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NV",
            "license": "5312",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "30359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.