Active NPI
Jean M Marie, MASSAGE THERAPIST
- Massage Therapist
- Hamburg, NY
National Provider Identifier
1215089925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 017139-1
- Practice address
- 133 Sunset CT
Suite 2
Hamburg, NY 14075-4282 - Phone
- (716) 515-5254
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 017139-1 | NY | Primary |
Addresses
Primary practice location
133 Sunset CT
Suite 2
Hamburg, NY 14075-4282
Mailing address
4390 Quinby Drive
Suite D
Hamburg, NY 14075
Phone (716) 515-5254
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 |
|---|---|---|---|
| 017139-1 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215089925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4390 QUINBY DRIVE",
"address_2": "SUITE D",
"city": "HAMBURG",
"state": "NY",
"postal_code": "14075",
"telephone_number": "716-515-5254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 SUNSET CT",
"address_2": "SUITE 2",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140754282",
"telephone_number": "716-515-5254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIE",
"first_name": "JEAN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "017139-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.