Active NPI
Chris L Widlund, LMP
- Massage Therapist
- Essex Junction, VT
National Provider Identifier
1881719201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00017639
- Practice address
- 21 Carmichael St Ste 204
Essex Junction, VT 05452-3186 - Phone
- (802) 233-0600
- NPI assigned
- Mar 21, 2007
- 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 | MA00017639 | WA | Primary |
Addresses
Primary practice location
21 Carmichael St Ste 204
Essex Junction, VT 05452-3186
Mailing address
21 Carmichael St Ste 204
Essex Junction, VT 05452-3186
Phone (802) 233-0600
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 |
|---|---|---|---|
| MA00017639 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1881719201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 CARMICHAEL ST STE 204",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054523186",
"telephone_number": "802-233-0600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 CARMICHAEL ST STE 204",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054523186",
"telephone_number": "802-233-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDLUND",
"first_name": "CHRIS",
"middle_name": "L",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00017639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essex Junction, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.