Individual provider Active NPI

Caitlyn Jean Baxter, LMT

  • Massage Therapist
  • Palmer, AK
National Provider Identifier
1770966517
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
101482 Issued in AK
Practice address
108 E Arctic Ave
Palmer, AK 99645-6254
Phone
(907) 745-4357
Fax
(907) 745-4606
NPI assigned
Jun 29, 2015
Last updated
Apr 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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 NU
Massage Therapist 225700000X 101482 AK Primary

Addresses

Primary practice location

108 E Arctic Ave
Palmer, AK 99645-6254

Mailing address

108 E Arctic Ave
Palmer, AK 99645-6254
Phone (907) 745-4357

Other names 1

  • Caitlyn Jean Borum Former name

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

LicenseStateTypeSpecialty
101482AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bionic Chiropractic 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1770966517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E ARCTIC AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456254",
            "telephone_number": "907-745-4357",
            "fax_number": "907-745-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E ARCTIC AVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456254",
            "telephone_number": "907-745-4357",
            "fax_number": "907-745-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "CAITLYN",
        "middle_name": "JEAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "101482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLYN",
            "last_name": "BORUM",
            "middle_name": "JEAN",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.