Individual provider Active NPI

Jacob Scott Freedle, CMT

  • Massage Therapist
  • Parker, CO
National Provider Identifier
1225303456
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
13221 Issued in CO
Practice address
10841 S Crossroads Dr Ste 9
Parker, CO 80134-9090
Phone
(720) 934-6583
NPI assigned
Mar 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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 13221 CO Primary

Addresses

Primary practice location

10841 S Crossroads Dr Ste 9
Parker, CO 80134-9090

Mailing address

10841 S Crossroads Dr Ste 9
Parker, CO 80134-9090
Phone (720) 934-6583

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
13221COMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1225303456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10841 S CROSSROADS DR STE 9",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801349090",
            "telephone_number": "720-934-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10841 S CROSSROADS DR STE 9",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801349090",
            "telephone_number": "720-934-6583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDLE",
        "first_name": "JACOB",
        "middle_name": "SCOTT",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "13221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.