Active NPI
Jamie Sueann Wilson, LMT
- Massage Therapist
- Bedford, TX
National Provider Identifier
1093313223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT129780
- Practice address
- 240 Harwood Rd Ste 3
Bedford, TX 76021-4189 - Phone
- (817) 680-3873
- NPI assigned
- Oct 9, 2020
- 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 | MT129780 | TX | Primary |
Addresses
Primary practice location
240 Harwood Rd Ste 3
Bedford, TX 76021-4189
Mailing address
6824 Meadowbrook Dr
Fort Worth, TX 76112-5245
Phone (817) 680-3873
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 |
|---|---|---|---|
| MT129780 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1093313223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6824 MEADOWBROOK DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761125245",
"telephone_number": "817-680-3873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 HARWOOD RD STE 3",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760214189",
"telephone_number": "817-680-3873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JAMIE",
"middle_name": "SUEANN",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-09",
"last_updated": "2020-10-09",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT129780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.