Active NPI
Jenaiya Aelin Ellis Delavega, LMT
- Massage Therapist
- Saint George, UT
National Provider Identifier
1124803978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13591986-4701
- Practice address
- 348 N Bluff St Ste 104
Saint George, UT 84770-5523 - Phone
- (360) 631-7567
- NPI assigned
- Aug 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA61479402 | WA | |
| Massage Therapist | 225700000X | 13591986-4701 | UT | Primary |
Addresses
Primary practice location
348 N Bluff St Ste 104
Saint George, UT 84770-5523
Mailing address
514 S 1990 E Apt 520
St George, UT 84790-5086
Phone (360) 631-7567
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 |
|---|---|---|---|
| 13591986-4701 | UT | MD | Massage Therapist |
| MA61479402 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1124803978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 S 1990 E APT 520",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847905086",
"telephone_number": "360-631-7567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "348 N BLUFF ST STE 104",
"city": "SAINT GEORGE",
"state": "UT",
"postal_code": "847705523",
"telephone_number": "360-631-7567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAVEGA",
"first_name": "JENAIYA",
"middle_name": "AELIN ELLIS",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-30",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61479402",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "UT",
"license": "13591986-4701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.