Active NPI
Jeffrey Allen Patrick, LMT
- Massage Therapist
- Springdale, AR
National Provider Identifier
1447848262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 8976
- Practice address
- 2105 Carnes Dr
Springdale, AR 72762-1536 - Phone
- (479) 222-0086
- NPI assigned
- Jan 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 8976 | AR | Primary |
Addresses
Primary practice location
2105 Carnes Dr
Springdale, AR 72762-1536
Mailing address
2105 Carnes Dr
Springdale, AR 72762-1536
Phone (479) 222-0086
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8976 | AR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1447848262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 CARNES DR",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727621536",
"telephone_number": "479-222-0086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 CARNES DR",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727621536",
"telephone_number": "479-222-0086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "JEFFREY",
"middle_name": "ALLEN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-07",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "AR",
"license": "8976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.