Individual provider Active NPI

Jennette Royster, NCTMB,CMT

  • Massage Therapist
  • Virginia Beach, VA
National Provider Identifier
1114096054
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0019004402 Issued in VA
Practice address
145 Burford Ave
Ste 100
Virginia Beach, VA 23451-5864
Phone
(757) 392-0414
Fax
(757) 392-0417
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0019004402 VA Primary

Addresses

Primary practice location

145 Burford Ave
Ste 100
Virginia Beach, VA 23451-5864

Mailing address

145 Burford Ave
Ste 100
Virginia Beach, VA 23451-5864
Phone (757) 392-0414

Other names 1

  • Jennette Johnson Former name

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
0019004402VAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114096054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 BURFORD AVE",
            "address_2": "STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515864",
            "telephone_number": "757-392-0414",
            "fax_number": "757-392-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 BURFORD AVE",
            "address_2": "STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515864",
            "telephone_number": "757-392-0414",
            "fax_number": "757-392-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYSTER",
        "first_name": "JENNETTE",
        "credential": "NCTMB,CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019004402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNETTE",
            "last_name": "JOHNSON",
            "credential": "NCTMB,CMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.