Individual provider Active NPI

Jennifer Percell, LMT

  • Massage Therapist
  • Lake City, FL
National Provider Identifier
1205231537
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA76001 Issued in FL
Practice address
1009 SW Main Blvd
Suite 110
Lake City, FL 32025-5781
Phone
(386) 487-6450
NPI assigned
Oct 29, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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 MA76001 FL Primary

Addresses

Primary practice location

1009 SW Main Blvd
Suite 110
Lake City, FL 32025-5781

Mailing address

1009 SW Main Blvd
Suite 110
Lake City, FL 32025-5781
Phone (386) 487-6450

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
MA76001FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1205231537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 SW MAIN BLVD",
            "address_2": "SUITE 110",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255781",
            "telephone_number": "386-487-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 SW MAIN BLVD",
            "address_2": "SUITE 110",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255781",
            "telephone_number": "386-487-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCELL",
        "first_name": "JENNIFER",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA76001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.