Individual provider Active NPI

Jessica N Marvin, LMT

  • Massage Therapist
  • Medford, OR
National Provider Identifier
1265196018
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
26549 Issued in OR
Practice address
836 E Main St Ste 3
Medford, OR 97504-7115
Phone
(541) 450-9098
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 26549 OR Primary

Addresses

Primary practice location

836 E Main St Ste 3
Medford, OR 97504-7115

Mailing address

233 Rogue River Hwy # 1184
Grants Pass, OR 97527-1600
Phone (541) 450-9098

Other practice location 1

333 SW 5th St Ste B
Grants Pass, OR 97526-2509
Phone (541) 507-9894

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
26549ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Medical Massage LLC Massage Therapist CurrentSince Jun 30, 2024 Accepting new patients
Axis Health, Inc. Massage Therapist CurrentSince Oct 1, 2021 Accepting new patients
Ryan Baker, D.C. P.C. CurrentSince Oct 1, 2021 Accepting new patients

Locations

333 SW 5th St
Ste B
Grants Pass, OR 97526
Phone (541) 471-0397

233 Rogue River Hwy
Grants Pass, OR 97527

836 E Main St
Ste 3
Medford, OR 97504
Phone (541) 450-9098

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1265196018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 ROGUE RIVER HWY # 1184",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975271600",
            "telephone_number": "541-450-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 E MAIN ST STE 3",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047115",
            "telephone_number": "541-450-9098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 SW 5th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975262509",
            "country_code": "US",
            "telephone_number": "541-507-9894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "JESSICA",
        "middle_name": "N",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "26549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.