Active NPI
Jami A Thibodeau, LMT
- Massage Therapist
- Springvale, ME
National Provider Identifier
1265718720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT4579
- Practice address
- 560 Main St
Springvale, ME 04083-1511 - Phone
- (207) 324-6364
- NPI assigned
- Oct 28, 2011
- Sex
- Female
- Sole proprietor
- No
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 | MT4579 | ME | Primary |
Addresses
Primary practice location
560 Main St
Springvale, ME 04083-1511
Mailing address
111 NE Pond Rd
Milton, NH 03851-4416
Phone (603) 817-2186
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 |
|---|---|---|---|
| MT4579 | ME | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319760000000",
"number": "1265718720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NE POND RD",
"city": "MILTON",
"state": "NH",
"postal_code": "038514416",
"telephone_number": "603-817-2186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 MAIN ST",
"city": "SPRINGVALE",
"state": "ME",
"postal_code": "040831511",
"telephone_number": "207-324-6364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBODEAU",
"first_name": "JAMI",
"middle_name": "A",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-28",
"last_updated": "2011-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ME",
"license": "MT4579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springvale, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.