Active NPI
Jennifer Stanley
- Massage Therapist
- St Charles, IL
National Provider Identifier
1235423146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.012757
- Practice address
- 210 S 5TH St Ste 202
Saint Charles, IL 60174-2700 - Phone
- (630) 945-3867
- NPI assigned
- Jun 8, 2011
- Last updated
- Jan 22, 2020
- 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 | 227.012757 | IL | Primary |
Addresses
Primary practice location
210 S 5TH St Ste 202
Saint Charles, IL 60174-2700
Mailing address
210 S 5TH St Ste 202
Saint Charles, IL 60174-2700
Phone (630) 945-3867
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 |
|---|---|---|---|
| 227.012757 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1235423146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 S 5TH ST STE 202",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601742700",
"telephone_number": "630-945-3867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 S 5TH ST STE 202",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601742700",
"telephone_number": "630-945-3867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANLEY",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-08",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.012757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
- St. Charles Pain and Wellness Center, LLC
- St. Charles Podiatry Assoc
- St. Charles Service Corporation (Olympia Chiropractic and Physical Therapy)
- St..Charles Modern Dental LLC
- Ashley Stalter
- Shannon Starr
- Timothy Staudacher, M.D.
- Stephanie Clorinda Stavropoulos
- STC Dental PLLC
- Tiffany Marie Steinbraker
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.