Individual provider Active NPI

Crystal Gilbert

  • Massage Therapist
  • Spring Grove, IL
National Provider Identifier
1235546581
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.006995 Issued in IL
Practice address
2100 RT 12 Ste 101
Spring Grove, IL 60081-7919
Phone
(815) 675-0675
NPI assigned
Jul 18, 2014
Last updated
Jul 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 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 227.006995 IL Primary

Addresses

Primary practice location

2100 RT 12 Ste 101
Spring Grove, IL 60081-7919

Mailing address

2100 RT 12 Ste 101
Spring Grove, IL 60081-7919
Phone (815) 675-0675

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
227.006995ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1235546581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 RT 12 STE 101",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "600817919",
            "telephone_number": "815-675-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RT 12 STE 101",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "600817919",
            "telephone_number": "815-675-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.006995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.