Jessica Ann Greenbaum, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT157 Issued in ME

Practice address

364 Sound Dr
Mount Desert, ME 04660-6612

Phone

(207) 276-3031

NPI assigned

Dec 2, 2011

Last updated

Dec 2, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessie Greenbaum Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1063780252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 SOUND DR",
            "city": "MOUNT DESERT",
            "state": "ME",
            "postal_code": "046606612",
            "telephone_number": "207-276-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 SOUND DR",
            "city": "MOUNT DESERT",
            "state": "ME",
            "postal_code": "046606612",
            "telephone_number": "207-276-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBAUM",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "GREENBAUM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Massage Therapist in Mount Desert, ME
• Providers in Mount Desert, ME by specialty
• Massage Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.