Individual provider Active NPI

Kathleen L Fleury-Dougherty, LMT

  • Massage Therapist
  • Peoria, AZ
National Provider Identifier
1821262346
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-20019 Issued in AZ
Practice address
8877 W Union Hills Dr Ste 300
Peoria, AZ 85382
Phone
(623) 583-8190
Fax
(623) 583-8788
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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 MT-20019 AZ Primary

Addresses

Primary practice location

8877 W Union Hills Dr Ste 300
Peoria, AZ 85382

Mailing address

8877 W Union Hills Dr Ste 300
Peoria, AZ 85382-3016
Phone (623) 583-8190

Other practice location 1

116 West St
Rutland, VT 05701-3455
Phone (802) 775-8080

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
MT-20019AZMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ellah Health Specialties, Inc. PastSince Sep 1, 2002 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.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1821262346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8877 W UNION HILLS DR STE 300",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823016",
            "telephone_number": "623-583-8190",
            "fax_number": "623-583-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8877 W UNION HILLS DR STE 300",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "623-583-8190",
            "fax_number": "623-583-8788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 West St",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057013455",
            "country_code": "US",
            "telephone_number": "802-775-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEURY-DOUGHERTY",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-20019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.