Active NPI
Kanidtha Chimjun
- Massage Therapist
- Webster, TX
National Provider Identifier
1902119035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT100877
- Practice address
- 200 Water St Apt 14101
Webster, TX 77598-5293 - Phone
- (832) 244-9250
- NPI assigned
- Jul 18, 2010
- Last updated
- Jul 18, 2010
- 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 | MT100877 | TX | Primary |
Addresses
Primary practice location
200 Water St Apt 14101
Webster, TX 77598-5293
Mailing address
200 Water St Apt 14101
Webster, TX 77598-5293
Phone (832) 244-9250
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 |
|---|---|---|---|
| MT100877 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279411200000",
"number": "1902119035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 WATER ST APT 14101",
"city": "WEBSTER",
"state": "TX",
"postal_code": "775985293",
"telephone_number": "832-244-9250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 WATER ST APT 14101",
"city": "WEBSTER",
"state": "TX",
"postal_code": "775985293",
"telephone_number": "832-244-9250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIMJUN",
"first_name": "KANIDTHA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-18",
"last_updated": "2010-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT100877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Webster, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.