Individual provider Active NPI

Kimberly Sjockeia Smith-Jones

  • Massage Therapist
  • Newark, NJ
National Provider Identifier
1073129680
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18KT01258800 Issued in NJ
Practice address
590 Irvine Turner Blvd
Newark, NJ 07112
Phone
(973) 332-5096
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 18KT01258800 NJ Primary

Addresses

Primary practice location

590 Irvine Turner Blvd
Newark, NJ 07112

Mailing address

2165 Morris Ave Ste 21
Union, NJ 07083-5913
Phone (862) 323-0942

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

LicenseStateTypeSpecialty
18KT01258800NJMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1073129680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 MORRIS AVE STE 21",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835913",
            "telephone_number": "862-323-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 IRVINE TURNER BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07112",
            "telephone_number": "973-332-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-JONES",
        "first_name": "KIMBERLY",
        "middle_name": "SJOCKEIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT01258800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.