Active NPI
Jane Dunn Edmonson, LMT
- Massage Therapist
- Killeen, TX
National Provider Identifier
1164790903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT101825
- Practice address
- 2100 E Stan Schlueter Loop
Suite 1
Killeen, TX 76542-3807 - Phone
- (254) 781-0105
- NPI assigned
- Dec 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT101825 | TX | Primary |
Addresses
Primary practice location
2100 E Stan Schlueter Loop
Suite 1
Killeen, TX 76542-3807
Mailing address
4110 Placid Creek Way
Round Rock, TX 78665-1194
Phone (225) 773-0222
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 |
|---|---|---|---|
| MT101825 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1164790903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4110 PLACID CREEK WAY",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786651194",
"telephone_number": "225-773-0222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 E STAN SCHLUETER LOOP",
"address_2": "SUITE 1",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765423807",
"telephone_number": "254-781-0105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONSON",
"first_name": "JANE",
"middle_name": "DUNN",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-07",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT101825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.