Active NPI
Jimmy Lee Adcock, LMP
- Massage Therapist
- Spokane, WA
National Provider Identifier
1033255336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00019287
- Practice address
- 327 W 8TH Ave Ste 222
Spokane, WA 99204-2557 - Phone
- (509) 624-0567
- NPI assigned
- Jan 30, 2007
- 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 | MA00019287 | WA | Primary |
Addresses
Primary practice location
327 W 8TH Ave Ste 222
Spokane, WA 99204-2557
Mailing address
3105 S Early Dawn CT
Spokane Valley, WA 99037-9385
Phone (509) 475-7395
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0184210 | Other | WA | LABOR AND INDUSTRIES |
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 |
|---|---|---|---|
| MA00019287 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033255336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 S EARLY DAWN CT",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "990379385",
"telephone_number": "509-475-7395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 W 8TH AVE STE 222",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042557",
"telephone_number": "509-624-0567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADCOCK",
"first_name": "JIMMY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00019287",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0184210",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.