Active NPI
Cassidy Randleas, LMT
- Massage Therapist
- Wichita, KS
National Provider Identifier
1881215523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2021-46215
- Practice address
- 10523 E 21St St N Ste 4
Wichita, KS 67206-3582 - Phone
- (785) 764-2366
- NPI assigned
- May 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 2021-46215 | KS | Primary |
Addresses
Primary practice location
10523 E 21St St N Ste 4
Wichita, KS 67206-3582
Mailing address
4520 E Douglas Ave
Wichita, KS 67208-3929
Phone (785) 764-2366
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 |
|---|---|---|---|
| 2021-46215 | KS | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1881215523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4520 E DOUGLAS AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672083929",
"telephone_number": "785-764-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10523 E 21ST ST N STE 4",
"city": "WICHITA",
"state": "KS",
"postal_code": "672063582",
"telephone_number": "785-764-2366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDLEAS",
"first_name": "CASSIDY",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-05",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "KS",
"license": "2021-46215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.