Jordan Herndon, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

121843 Issued in AK

Practice address

7731 E Northern Lights Blvd Ste 220
Anchorage, AK 99504-3572

Phone

(907) 280-9991

NPI assigned

Aug 15, 2018

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 identifiers 1

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1063992444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W EDINBOROUGH DR",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456513",
            "telephone_number": "907-521-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7731 E NORTHERN LIGHTS BLVD STE 220",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995043572",
            "telephone_number": "907-280-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "JORDAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "121843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AK LMT LICENSE",
            "identifier": "121843",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manuela Hernandez, RN
• Miguel Hernandez
• Sonia Maricruz Hernandez
• Veronica Sofia Hernandez
• Charles Michael Herndon, M.D.
• Robert Phillip Herndon
• William Leroy Herold, M.D.
• Rachel Herrera
• Tatiana Herrera
• Cody Leland Herrick, CCC-SLP

• Massage Therapist in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.