Individual provider Active NPI

Gilbert P Simon Jr., LMT

  • Massage Therapist
  • Federal Way, WA
National Provider Identifier
1346801743
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60947905 Issued in WA
Practice address
33650 6TH Ave S Ste 100
Federal Way, WA 98003-6754
Phone
(253) 942-3303
NPI assigned
Jun 26, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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 MA60947905 WA Primary

Addresses

Primary practice location

33650 6TH Ave S Ste 100
Federal Way, WA 98003-6754

Mailing address

6223 62ND Ave W
University Place, WA 98467-4942
Phone (253) 278-1947

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL simongil24@gmail.com Direct

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
MA60947905WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1346801743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6223 62ND AVE W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984674942",
            "telephone_number": "253-278-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33650 6TH AVE S STE 100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036754",
            "telephone_number": "253-942-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "GILBERT",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60947905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "simongil24@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "33650 6th Ave S Ste 100",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980036754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.

Verify at the official NPI Registry.