Active NPI
Jennifer L Cleary, LMT
- Massage Therapist
- Louisville, KY
National Provider Identifier
1386096063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 167182
- Practice address
- 10306 Shelbyville Rd
Louisville, KY 40223-2914 - Phone
- (502) 245-7334
- NPI assigned
- Jul 6, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reflexologist | 173C00000X | 167182 | KY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 167182 | KY | |
| Massage Therapist | 225700000X | 167182 | KY | Primary |
Addresses
Primary practice location
10306 Shelbyville Rd
Louisville, KY 40223-2914
Mailing address
10206 Easum Rd
Louisville, KY 40299-4118
Other practice location 1
10206 Easum Rd
Louisville, KY 40299-4118
Phone (502) 417-2804
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Louisville |
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 |
|---|---|---|---|
| 167182 | KY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588896000000",
"number": "1386096063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10206 EASUM RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402994118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10306 SHELBYVILLE RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402232914",
"telephone_number": "502-245-7334"
}
],
"practiceLocations": [
{
"address_1": "10206 Easum Rd",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402994118",
"country_code": "US",
"telephone_number": "502-417-2804",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLEARY",
"first_name": "JENNIFER",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-06",
"last_updated": "2020-05-08",
"certification_date": "2020-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "173C00000X",
"taxonomy_group": "",
"desc": "Reflexologist",
"state": "KY",
"license": "167182",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "KY",
"license": "167182",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "KY",
"license": "167182",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Louisville",
"affiliation": "N",
"address_1": "10306 Shelbyville Rd",
"city": "Louisville",
"state": "KY",
"country_code": "US",
"postal_code": "402232914",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.