Active NPI
Jenna L Bensen, LMT
- Massage Therapist
- Latham, NY
National Provider Identifier
1053564906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 020905-1
- Practice address
- 578 New Loudon Rd
Latham, NY 12110-4038 - Phone
- (518) 389-2200
- Fax
- (518) 389-2083
- NPI assigned
- Oct 23, 2008
- Last updated
- Oct 23, 2008
- 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 | 020905-1 | NY | Primary |
Addresses
Primary practice location
578 New Loudon Rd
Latham, NY 12110-4038
Mailing address
578 New Loudon Rd
Latham, NY 12110-4038
Phone (518) 389-2200
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 |
|---|---|---|---|
| 020905-1 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224720000000",
"number": "1053564906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "578 NEW LOUDON RD",
"city": "LATHAM",
"state": "NY",
"postal_code": "121104038",
"telephone_number": "518-389-2200",
"fax_number": "518-389-2083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "578 NEW LOUDON RD",
"city": "LATHAM",
"state": "NY",
"postal_code": "121104038",
"telephone_number": "518-389-2200",
"fax_number": "518-389-2083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSEN",
"first_name": "JENNA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-23",
"last_updated": "2008-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "020905-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.