Individual provider Active NPI

Jecory Brumfield, LMT

  • Massage Therapist
  • Conyers, GA
National Provider Identifier
1073197554
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT013234 Issued in GA
Practice address
1271 Parker Rd SE
Conyers, GA 30094-5957
Phone
(678) 400-3278
NPI assigned
May 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

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 MT013234 GA Primary

Addresses

Primary practice location

1271 Parker Rd SE
Conyers, GA 30094-5957

Mailing address

3624 Summit Pnes
Decatur, GA 30034-3857
Phone (404) 272-5794

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
MT013234GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1073197554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 SUMMIT PNES",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300343857",
            "telephone_number": "404-272-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 PARKER RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945957",
            "telephone_number": "678-400-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMFIELD",
        "first_name": "JECORY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT013234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.