Active NPI
Kendall T Joy, LMT
- Massage Therapist
- Portland, OR
National Provider Identifier
1013776103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27174
- Practice address
- 2933 NE Broadway St
Portland, OR 97232-1760 - Phone
- (541) 207-4804
- NPI assigned
- Mar 19, 2024
- Sex
- Male
- 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 | 27174 | OR | Primary |
Addresses
Primary practice location
2933 NE Broadway St
Portland, OR 97232-1760
Mailing address
110 SW Nevada St
Portland, OR 97219-2242
Phone (541) 207-4804
Other names 1
- Kendall T Joy
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 |
|---|---|---|---|
| 27174 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710806400000",
"number": "1013776103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 SW NEVADA ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972192242",
"telephone_number": "541-207-4804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2933 NE BROADWAY ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321760",
"telephone_number": "541-207-4804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOY",
"first_name": "KENDALL",
"middle_name": "T",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-19",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "27174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KENDALL",
"last_name": "JOY",
"middle_name": "T",
"credential": "LMT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.