Individual provider Active NPI

Jayne L Potvin, LMT

  • Massage Therapist
  • Millinocket, ME
National Provider Identifier
1093972770
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT2179 Issued in ME
Practice address
51 Riverside Dr
Millinocket, ME 04462-2004
Phone
(207) 210-0007
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2008

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 MT2179 ME Primary

Addresses

Primary practice location

51 Riverside Dr
Millinocket, ME 04462-2004

Mailing address

51 Riverside Dr
Millinocket, ME 04462-2004
Phone (207) 210-0007

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
MT2179MEMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1093972770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 RIVERSIDE DR",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044622004",
            "telephone_number": "207-210-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 RIVERSIDE DR",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044622004",
            "telephone_number": "207-210-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTVIN",
        "first_name": "JAYNE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT2179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millinocket, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.