Individual provider Active NPI

Jeremy Kyncl, LMT

  • Massage Therapist
  • Spokane Valley, WA
National Provider Identifier
1326311531
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
60246652 Issued in WA
Practice address
14222 E Sprague Ave
Spokane Valley, WA 99216-2188
Phone
(509) 891-1999
Fax
(509) 891-8119
NPI assigned
Feb 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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 60246652 WA Primary

Addresses

Primary practice location

14222 E Sprague Ave
Spokane Valley, WA 99216-2188

Mailing address

14222 E Sprague Ave
Spokane Valley, WA 99216-2188
Phone (509) 891-1999

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
60246652WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Brickhouse Massage and Coffee Bar Massage Therapist Past Accepting new patients

Organizations & group practices 1

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": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1326311531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14222 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162188",
            "telephone_number": "509-891-1999",
            "fax_number": "509-891-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14222 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162188",
            "telephone_number": "509-891-1999",
            "fax_number": "509-891-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYNCL",
        "first_name": "JEREMY",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60246652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.