Jill Renee Kozhevnikov, PTA

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

8046 Issued in NH

Practice address

12 Middle St
Amherst, NH 03031-2950

Phone

(617) 319-7175

NPI assigned

Apr 22, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lymph & Bodywork LLC

  • Massage Therapist
  • Amherst, NH
  • NPI 1962266197
  NPD Authorized official

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1154596005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MIDDLE ST",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030312950",
            "telephone_number": "617-319-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MIDDLE ST",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030312950",
            "telephone_number": "617-319-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZHEVNIKOV",
        "first_name": "JILL",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "7779",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NH",
            "license": "8046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kindred Psychotherapy and Wellness, PLLC
• Raymond T King, MD
• Molly J Klapka, BCBA
• Robert C. Kolodny, M.D.
• Delia Kostner, PH.D.
• Krislan of New England, LLC
• Keith A Lammers, MD
• Jessica Launh, APRN
• Heather M Lawson, M.S., L.C.M.H.C.
• John Joseph Leary III, PT.

• Massage Therapist in Amherst, NH
• Providers in Amherst, NH by specialty
• Massage Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.

Verify at the official NPI Registry.