Active NPI
Jennifer Dietz, LMT
- Massage Therapist
- Gardiner, NY
National Provider Identifier
1376007179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 030324-1
- Practice address
- 2356 Route 44 55 Ste F
Gardiner, NY 12525-5335 - Phone
- (845) 590-1298
- NPI assigned
- Jan 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 030324-1 | NY | Primary |
Addresses
Primary practice location
2356 Route 44 55 Ste F
Gardiner, NY 12525-5335
Mailing address
95 Tuthilltown Rd
Gardiner, NY 12525-5514
Phone (845) 590-1298
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
| License | State | Type | Specialty |
|---|---|---|---|
| 030324-1 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548374400000",
"number": "1376007179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 TUTHILLTOWN RD",
"city": "GARDINER",
"state": "NY",
"postal_code": "125255514",
"telephone_number": "845-590-1298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2356 ROUTE 44 55 STE F",
"city": "GARDINER",
"state": "NY",
"postal_code": "125255335",
"telephone_number": "845-590-1298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETZ",
"first_name": "JENNIFER",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-25",
"last_updated": "2019-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "030324-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gardiner, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.