Jessica A McInnis, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

126988 Issued in AK

Practice address

1212 W Mystery Ave Ste B
Wasilla, AK 99654-6335

Phone

(907) 521-8002

NPI assigned

Oct 4, 2019

Last updated

Oct 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alaska Massage Studio LLC

  dba Alaska Massage Studio

  • Massage Therapist
  • Wasilla, AK
  • NPI 1083441554

  Single Specialty

  NPD
• Alaska Massage Studio LLC

  dba Alaska Massage Studio

  • Massage Therapist
  • Wasilla, AK
  • NPI 1447798996

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1265073746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8753 E ELDORADO CIR",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458052",
            "telephone_number": "601-201-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W MYSTERY AVE STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546335",
            "telephone_number": "907-521-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "126988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "VagaroPro",
            "affiliation": "N",
            "address_1": "1212 W Mystery Ave Ste B",
            "city": "Wasilla",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996546335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samuel T McGraw
• Madison R McGuire
• Rebebcca Theresa McGuire, PSS, CT
• Brian McGurgen
• Laura McHenry
• Kenneth Bryan McInnis, LPC
• Gena McKee
• Brianna McKeel
• Sydnie McKinley
• Danielle McKinney, PA-C

• Massage Therapist in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.