Kellie Jaymes, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT109106 Issued in TX

Practice address

151 US Highway 69 N Ste 800
Bullard, TX 75757-5184

Phone

(903) 894-4404

NPI assigned

Feb 13, 2020

Last updated

Feb 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1356974703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 INWOOD DR",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757575415",
            "telephone_number": "903-574-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 US HIGHWAY 69 N STE 800",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757575184",
            "telephone_number": "903-894-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYMES",
        "first_name": "KELLIE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT109106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "practicalbodyworks@aol.com",
            "affiliation": "N",
            "address_1": "151 US Highway 69 N Ste 800",
            "city": "Bullard",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757575184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Massage Therapist in Bullard, TX
• Providers in Bullard, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.