Individual provider Active NPI

Montrell Nigel Jackson, LMT,MTI,CPE

  • Massage Therapist
  • Houston, TX
National Provider Identifier
1194367243
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT119368 Issued in TX
Practice address
5959 FM 1960 Rd W Apt 1136
Houston, TX 77069-4122
Phone
(713) 876-9034
NPI assigned
Oct 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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 MT119368 TX Primary

Addresses

Primary practice location

5959 FM 1960 Rd W Apt 1136
Houston, TX 77069-4122

Mailing address

5959 FM 1960 Rd W Apt 1136
Houston, TX 77069-4122
Phone (713) 876-9034

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
MT119368TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1194367243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 FM 1960 RD W APT 1136",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694122",
            "telephone_number": "713-876-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 FM 1960 RD W APT 1136",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694122",
            "telephone_number": "713-876-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MONTRELL",
        "middle_name": "NIGEL",
        "credential": "LMT,MTI,CPE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT119368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.