Individual provider Active NPI

Jalal Gazi Hamed

  • Massage Therapist
  • Eagle River, AK
National Provider Identifier
1356150304
Registry record updated Jan 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
233645 Issued in AK
Practice address
12812 Old Glenn Hwy Ste A8
Eagle River, AK 99577-7003
Phone
(727) 667-2665
NPI assigned
Jan 4, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2025

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 233645 AK Primary

Addresses

Primary practice location

12812 Old Glenn Hwy Ste A8
Eagle River, AK 99577-7003

Mailing address

12401 Lake St Apt 1
Eagle River, AK 99577-6901
Phone (727) 667-2665

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
233645AKMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1735948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735948800000",
    "number": "1356150304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 LAKE ST APT 1",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995776901",
            "telephone_number": "727-667-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 OLD GLENN HWY STE A8",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777003",
            "telephone_number": "727-667-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMED",
        "first_name": "JALAL",
        "middle_name": "GAZI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-04",
        "last_updated": "2025-01-04",
        "certification_date": "2025-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "233645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2025; 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.