NPIMap

Organization Active NPI

West Side Wellness, LLC

  • Massage Therapist
  • Province, RI
National Provider Identifier
1417215690
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT01476 Issued in RI
Legal business name
WEST SIDE WELLNESS, LLC
Practice address
376 West Fountain Street
Province, RI 02903
Phone
(401) 274-2225
Fax
(401) 274-2228
NPI assigned
Apr 25, 2012
Last updated
Oct 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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

Authorized official

Name
Jennifer Rita Raimondi, LMTNPI 1992063168
Title
Owner
Phone
(401) 274-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT01801 RI
Massage Therapist 225700000X MT01765 RI
Massage Therapist 225700000X MT01476 RI Primary

Addresses

Primary practice location

376 West Fountain Street
Province, RI 02903

Mailing address

376 West Fountain Street
Province, RI 02903
Phone (401) 274-2225

National Provider Directory

National Provider Directory

Locations

376 W Fountain St
Providence, RI 02903
Phone (401) 274-2225

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508457600000",
    "number": "1417215690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 WEST FOUNTAIN STREET",
            "city": "PROVINCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-274-2225",
            "fax_number": "401-274-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 WEST FOUNTAIN STREET",
            "city": "PROVINCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-274-2225",
            "fax_number": "401-274-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2017-10-20",
        "status": "A",
        "authorized_official_last_name": "RAIMONDI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-274-2225",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "RI",
            "license": "MT01801",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "RI",
            "license": "MT01765",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "RI",
            "license": "MT01476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.