Individual provider Active NPI

Violet Kissel, LMT

  • Massage Therapist
  • Wasilla, AK
National Provider Identifier
1811774185
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
209839 Issued in AK
Practice address
436 N Main St
Wasilla, AK 99654-7018
Phone
(907) 376-8020
NPI assigned
Sep 11, 2023
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 209839 AK Primary

Addresses

Primary practice location

436 N Main St
Wasilla, AK 99654-7018

Mailing address

436 N Main St
Wasilla, AK 99654-7018
Phone (907) 376-8020

Other practice location 1

12812 Old Glenn Hwy Ste A8
Eagle River, AK 99577-7003
Phone (907) 696-8020

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
209839AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Payne Clinics LLC PastSince Sep 17, 2023 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": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1811774185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547018",
            "telephone_number": "907-376-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547018",
            "telephone_number": "907-376-8020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12812 Old Glenn Hwy Ste A8",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995777003",
            "country_code": "US",
            "telephone_number": "907-696-8020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSEL",
        "first_name": "VIOLET",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "209839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.