Active NPI
Jessica Campbell, MASSAGE THERAPIST
- Massage Therapist
- Wasilla, AK
National Provider Identifier
1306294392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 101411
- Practice address
- 1701 N Seward Meridian Pkwy
Wasilla, AK 99654-6682 - Phone
- (907) 357-7463
- Fax
- (907) 376-5270
- NPI assigned
- May 31, 2016
- 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 | 101411 | AK | Primary |
Addresses
Primary practice location
1701 N Seward Meridian Pkwy
Wasilla, AK 99654-6682
Mailing address
416 W Sunflower Cir
Wasilla, AK 99654-1365
Phone (907) 841-8658
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 |
|---|---|---|---|
| 101411 | AK | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1306294392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 W SUNFLOWER CIR",
"city": "WASILLA",
"state": "AK",
"postal_code": "996541365",
"telephone_number": "907-841-8658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N SEWARD MERIDIAN PKWY",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546682",
"telephone_number": "907-357-7463",
"fax_number": "907-376-5270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "JESSICA",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AK",
"license": "101411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.