Individual provider Active NPI

Keiarah Spence

  • Massage Therapist
  • Colorado Springs, CO
National Provider Identifier
1952125940
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT.0026103 Issued in CO
Practice address
6120 Barnes Rd Ste 160
Colorado Springs, CO 80922-2605
Phone
(719) 344-9270
NPI assigned
Nov 14, 2024
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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.0026103 CO Primary

Addresses

Primary practice location

6120 Barnes Rd Ste 160
Colorado Springs, CO 80922-2605

Mailing address

6055 Pioneer Mesa Dr
Colorado Springs, CO 80923-8806
Phone (719) 439-1429

Other practice location 1

6055 Pioneer Mesa Dr
Colorado Springs, CO 80923-8806
Phone (719) 439-1429

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.0026103COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Balance Family Wellness PLLC CurrentSince Nov 17, 2024 Accepting new patients

Locations

6120 Barnes Rd
Ste 160
Colorado Springs, CO 80922
Phone (719) 344-9270

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1952125940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 PIONEER MESA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809238806",
            "telephone_number": "719-439-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 BARNES RD STE 160",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222605",
            "telephone_number": "719-344-9270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6055 Pioneer Mesa Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809238806",
            "country_code": "US",
            "telephone_number": "719-439-1429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "KEIARAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0026103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.