Active NPI
Marla Bauknecht
- Massage Therapist
- Anchorage, AK
National Provider Identifier
1962217331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 218072
- Practice address
- 6634 Lake Otis Pkwy Ste a
Anchorage, AK 99507-2176 - Phone
- (907) 522-3511
- Fax
- (907) 522-8551
- NPI assigned
- Feb 11, 2025
- 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 | 218072 | AK | Primary |
Addresses
Primary practice location
6634 Lake Otis Pkwy Ste a
Anchorage, AK 99507-2176
Mailing address
6634 Lake Otis Pkwy Ste a
Anchorage, AK 99507-2176
Phone (907) 522-3511
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 |
|---|---|---|---|
| 218072 | AK | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports & Spinal Injury Clinic,LLC | Multi-Specialty | Current | Accepting new patients |
| Sports & Spinal Injury Clinic, LLC | Multi-Specialty | Past | Accepting new patients |
Locations
6634 Lake Otis Pkwy
Ste A
Anchorage, AK 99507
Phone (907) 522-3511
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1962217331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6634 LAKE OTIS PKWY STE A",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995072176",
"telephone_number": "907-522-3511",
"fax_number": "907-522-8551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6634 LAKE OTIS PKWY STE A",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995072176",
"telephone_number": "907-522-3511",
"fax_number": "907-522-8551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUKNECHT",
"first_name": "MARLA",
"sole_proprietor": "YES",
"sex": "U",
"enumeration_date": "2025-02-11",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "AK",
"license": "218072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.