Jacob Starkweather, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

5170 S 76TH St Ste 107
Greendale, WI 53129-1112

Phone

(414) 482-5170

NPI assigned

Oct 2, 2021

Last updated

Oct 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1633132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1225700719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 CAMDEN CT UNIT D",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531866867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 S 76TH ST STE 107",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531291112",
            "telephone_number": "414-482-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARKWEATHER",
        "first_name": "JACOB",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-02",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "massagebook",
            "affiliation": "N",
            "address_1": "5170 S 76th St Ste 107",
            "city": "Greendale",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531291112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Massage Therapist in Greendale, WI
• Providers in Greendale, WI by specialty
• Massage Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; 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.