Jade Vine Massage

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

121821 Issued in AK

Legal business name

JADE VINE MASSAGE

Practice address

43335 Kalifornsky Beach Rd Ste 25
Soldotna, AK 99669-8280

Phone

(907) 394-8345

Fax

(907) 283-5350

NPI assigned

Nov 1, 2017

Organization subpart

No

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

Authorized official

Name

Hannah Camilla Nusbaum, LMTNPI 1316459100

Title

Owner

Phone

(907) 394-8645

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hannah Camilla Nusbaum, LMT

  • Massage Therapist
  • Soldotna, AK
  • NPI 1316459100

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1407368293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 COURTNEY DR",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996116646",
            "telephone_number": "907-394-8345",
            "fax_number": "907-283-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43335 KALIFORNSKY BEACH RD STE 25",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698280",
            "telephone_number": "907-394-8345",
            "fax_number": "907-283-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JADE VINE MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "NUSBAUM",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_middle_name": "CAMILLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-394-8645",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "121821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iris Ann Isham
• Kathryn Ishnook
• J - Care Coordinatio, LLC.
• Shawna Jackson
• Linda Ann Jacobsen, LCSW
• Riley M Jagd
• Kristina James, MD
• Elizabeth Jamison
• Arlene Jasky
• George A Jedlicka, D.M.D.

• Massage Therapist in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.