Jeneanne A Harris, MT

Key facts

NPI

1437635844

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

Practice address

43 Wood Lake Rd
Kincheloe, MI 49788-1108

Phone

(906) 322-4898

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Medical Technician

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 21, 2023.

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1437635844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WOOD LAKE RD",
            "city": "KINCHELOE",
            "state": "MI",
            "postal_code": "497881108",
            "telephone_number": "906-322-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WOOD LAKE RD",
            "city": "KINCHELOE",
            "state": "MI",
            "postal_code": "497881108",
            "telephone_number": "906-322-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JENEANNE",
        "middle_name": "A",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kincheloe, MI

• James E Adamo, D.D.S.
• Rafael Parsons Aguirre, LMSW
• Sidney D Andrews, D.D.S.
• Megan Marie Bruci
• William R Gillette IV, D.D.S.
• Eric John Hayhurst, D.D.S.
• Kinross Charter Township
• Jamie Lester, FNP
• Payton Leigh Mastaw
• Kacey McFarland

All providers in Kincheloe, MI · Massage Therapist in Michigan