Individual provider Active NPI

Jeannine Bowman, LMT

  • Massage Therapist
  • Springfield, OR
National Provider Identifier
1427577568
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
23705 Issued in OR
Practice address
1717 Centennial Blvd Ste 4
Springfield, OR 97477-3378
Phone
(541) 505-2756
NPI assigned
Sep 10, 2017
Last updated
Feb 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 23705 OR Primary

Addresses

Primary practice location

1717 Centennial Blvd Ste 4
Springfield, OR 97477-3378

Mailing address

1717 Centennial Blvd Ste 4
Springfield, OR 97477-3378
Phone (541) 505-2756

Other identifiers 1

IdentifierTypeStateIssuer
23705OtherORLICENSED MASSAGE THERAPIST

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

LicenseStateTypeSpecialty
23705ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1505001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1427577568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 CENTENNIAL BLVD STE 4",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773378",
            "telephone_number": "541-505-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 CENTENNIAL BLVD STE 4",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773378",
            "telephone_number": "541-505-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JEANNINE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-10",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "23705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASSAGE THERAPIST",
            "identifier": "23705",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.