Individual provider Active NPI

Jessabella Brown

  • Massage Therapist
  • Eugene, OR
National Provider Identifier
1346014578
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
LMT-27282 Issued in OR
Practice address
2286 Oakmont Way
Eugene, OR 97401-5519
Phone
(541) 484-5777
NPI assigned
Nov 8, 2023
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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 LMT-27282 OR Primary

Addresses

Primary practice location

2286 Oakmont Way
Eugene, OR 97401-5519

Mailing address

87551 Cedar Flat Rd
Springfield, OR 97478-8628
Phone (504) 909-8881

Other practice location 1

87551 Cedar Flat Rd
Springfield, OR 97478-8628
Phone (504) 909-8881

Other names 1

  • Jessica Bedortha Other name

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
LMT-27282ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regen Or CurrentSince Feb 28, 2024 Accepting new patients
Absolute Wellness, PC PastSince Nov 12, 2023 Accepting new patients

Locations

2286 Oakmont Way
Eugene, OR 97401
Phone (541) 484-5777

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1346014578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87551 CEDAR FLAT RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974788628",
            "telephone_number": "504-909-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2286 OAKMONT WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015519",
            "telephone_number": "541-484-5777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87551 Cedar Flat Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974788628",
            "country_code": "US",
            "telephone_number": "504-909-8881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JESSABELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "LMT-27282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BEDORTHA",
            "credential": "LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.