Active NPI
Crystal Shante Rodriguez, LMT
- Massage Therapist
- Henderson, NV
National Provider Identifier
1851819353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- NVMT.8619
- Practice address
- 105 N Pecos Rd
Henderson, NV 89074-7324 - Phone
- (702) 565-1243
- Fax
- (702) 565-1245
- NPI assigned
- Sep 5, 2017
- 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 | NVMT.8619 | NV | Primary |
Addresses
Primary practice location
105 N Pecos Rd
Henderson, NV 89074-7324
Mailing address
105 N Pecos Rd
Henderson, NV 89074-7324
Phone (702) 565-1243
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 |
|---|---|---|---|
| NVMT.8619 | NV | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1851819353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N PECOS RD",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890747324",
"telephone_number": "702-565-1243",
"fax_number": "702-565-1245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N PECOS RD",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890747324",
"telephone_number": "702-565-1243",
"fax_number": "702-565-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "CRYSTAL",
"middle_name": "SHANTE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NV",
"license": "NVMT.8619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.