Individual provider Active NPI

Michelle Denise Reisinger, LMT

  • Massage Therapist
  • Clarksville, TN
National Provider Identifier
1801091277
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
10420 Issued in TN
Practice address
1820 Madison St Ste D
Clarksville, TN 37043-8037
Phone
(931) 624-4333
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 127526 AK
Massage Therapist 225700000X 10420 TN Primary

Addresses

Primary practice location

1820 Madison St Ste D
Clarksville, TN 37043-8037

Mailing address

3649 Steeplechase LN
Hopkinsville, KY 42240-4004
Phone (931) 624-4333

Other practice location 1

1716 Memorial Dr Ste D
Clarksville, TN 37043-4542
Phone (931) 624-4333

Other identifiers 2

IdentifierTypeStateIssuer
127526OtherAKLMT
10420OtherTNLMT

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
10420TNMDPharmacist
127526AKMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1801091277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3649 STEEPLECHASE LN",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422404004",
            "telephone_number": "931-624-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 MADISON ST STE D",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438037",
            "telephone_number": "931-624-4333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1716 Memorial Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370434542",
            "country_code": "US",
            "telephone_number": "931-624-4333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISINGER",
        "first_name": "MICHELLE",
        "middle_name": "DENISE",
        "name_prefix": "Miss",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "127526",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TN",
            "license": "10420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "127526",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "10420",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.