Active NPI
Kana Moll
- Massage Therapist
- Eugene, OR
National Provider Identifier
1982955803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12091
- Practice address
- 144 E 14TH Ave
Eugene, OR 97401-3533 - Phone
- (541) 359-9942
- NPI assigned
- Oct 2, 2012
- 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 | 12091 | OR | Primary |
Addresses
Primary practice location
144 E 14TH Ave
Eugene, OR 97401-3533
Mailing address
144 E 14TH Ave
Eugene, OR 97401-3533
Phone (541) 359-9942
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93029 | Other | OR | PACIFICSOURCE |
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 |
|---|---|---|---|
| 12091 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1982955803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 E 14TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974013533",
"telephone_number": "541-359-9942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 E 14TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974013533",
"telephone_number": "541-359-9942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLL",
"first_name": "KANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-02",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "OR",
"license": "12091",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICSOURCE",
"identifier": "93029",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.