Zakkiyya Crolle-Jordan, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

0019010003 Issued in VA

Practice address

1213 Laskin Rd Ste 202
Virginia Beach, VA 23451-5260

Phone

(732) 682-9299

NPI assigned

Feb 14, 2020

Last updated

Feb 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1437782711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 LASKIN RD STE 202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515260",
            "telephone_number": "732-682-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 LASKIN RD STE 202",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515260",
            "telephone_number": "732-682-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROLLE-JORDAN",
        "first_name": "ZAKKIYYA",
        "name_prefix": "Miss",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019010003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Zeeserenity.weebly.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Website",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "1213 Laskin Rd Ste 202",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234515260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• June Toledo Crisostomo
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• Elizabeth Lee Crockett, PA
• Tonesia Croft
• Charles Douglas Crombie, CSAC
• Patricia Crombie
• Matthew S. Cronan, DMD
• Shannon Cronan, OTR/L
• Christine D Cronin, RPH

• Massage Therapist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Massage Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.