Active NPI
Caroline Marie Carballa, LMT
- Massage Therapist
- Gasport, NY
National Provider Identifier
1790120020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 026968-1
- Practice address
- 4437 Main St
Gasport, NY 14067-9201 - Phone
- (716) 772-2200
- NPI assigned
- Apr 30, 2013
- 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 | 026968-1 | NY | Primary |
Addresses
Primary practice location
4437 Main St
Gasport, NY 14067-9201
Mailing address
PO Box 281
Gasport, NY 14067-0281
Phone (716) 772-2200
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 |
|---|---|---|---|
| 026968-1 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gasport Chiropractic & Wellness, PC | 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.
-
- Chiropractor
- Gasport, NY
- NPI 1811068844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367280000000",
"number": "1790120020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 281",
"city": "GASPORT",
"state": "NY",
"postal_code": "140670281",
"telephone_number": "716-772-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4437 MAIN ST",
"city": "GASPORT",
"state": "NY",
"postal_code": "140679201",
"telephone_number": "716-772-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBALLA",
"first_name": "CAROLINE",
"middle_name": "MARIE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-30",
"last_updated": "2013-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "026968-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gasport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.