Individual provider Active NPI

Marla Bauknecht

  • Massage Therapist
  • Anchorage, AK
National Provider Identifier
1962217331
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
218072 Issued in AK
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

Updated by the provider on Feb 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 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

LicenseStateTypeSpecialty
218072AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports & Spinal Injury Clinic,LLC Multi-Specialty CurrentSince Feb 23, 2025 Accepting new patients
Sports & Spinal Injury Clinic, LLC Multi-Specialty PastSince Feb 23, 2025 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.

Verify at the official NPI Registry.