Active NPI
Diana J Kelley, L.M.T.
- Massage Therapist
- Central Point, OR
National Provider Identifier
1790054948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13273
- Practice address
- 1205 Plaza Blvd
Suite F
Central Point, OR 97502-2683 - Phone
- (541) 282-3496
- NPI assigned
- Dec 16, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reflexologist | 173C00000X | 13273 | OR | |
| Massage Therapist | 225700000X | 13273 | OR | Primary |
Addresses
Primary practice location
1205 Plaza Blvd
Suite F
Central Point, OR 97502-2683
Mailing address
404 Silver Creek Dr
Central Point, OR 97502-5007
Phone (541) 282-3496
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 |
|---|---|---|---|
| 13273 | OR | MD | Reflexologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1790054948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 SILVER CREEK DR",
"city": "CENTRAL POINT",
"state": "OR",
"postal_code": "975025007",
"telephone_number": "541-282-3496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 PLAZA BLVD",
"address_2": "SUITE F",
"city": "CENTRAL POINT",
"state": "OR",
"postal_code": "975022683",
"telephone_number": "541-282-3496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "DIANA",
"middle_name": "J",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-16",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "173C00000X",
"taxonomy_group": "",
"desc": "Reflexologist",
"state": "OR",
"license": "13273",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "13273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Central Point, OR
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.