Jacob Jon Henness, LMT MA

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT04134 Issued in AZ

Practice address

3543 N 7 St
Phoenix, AZ 85014

Phone

(602) 263-8484

Fax

(602) 263-3697

NPI assigned

Mar 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jacob Jon Henness Sr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407985393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5638 W GLENROSA",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85031",
            "telephone_number": "623-247-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3543 N 7 ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85014",
            "telephone_number": "602-263-8484",
            "fax_number": "602-263-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESS",
        "first_name": "JACOB",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "credential": "LMT MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT04134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "HENNESS",
            "middle_name": "JON",
            "prefix": "MR.",
            "suffix": "SR.",
            "credential": "LMT MA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jasmine Moffett Henley, PHARM.D.
• Robert J. Henley, PH.D.
• Marcus L Henline, D.C.
• Glenda R Henman, LPC
• Ashleigh Brooke Henneberger, MSW
• Brianna Hennessey
• Marissa Hennigan, BS-SLPA
• David Geoffrey Henninger, P.A.-C
• Cassandra Henrichsen, RBT
• Mary Elaine Henricksen, RN

• Massage Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Massage Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.