Active NPI
Jeremiah James Hartley, LMT
- Massage Therapist
- Wasilla, AK
National Provider Identifier
1457165748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 207404
- Practice address
- 591 N Knik St Ste E
Wasilla, AK 99654-7062 - Phone
- (907) 308-0664
- NPI assigned
- Feb 5, 2025
- Sex
- Male
- Sole proprietor
- No
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 | 207404 | AK | Primary |
Addresses
Primary practice location
591 N Knik St Ste E
Wasilla, AK 99654-7062
Mailing address
800 N Win Cir
Wasilla, AK 99654-6741
Phone (907) 240-1266
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 |
|---|---|---|---|
| 207404 | AK | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738713600000",
"number": "1457165748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 N WIN CIR",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546741",
"telephone_number": "907-240-1266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "591 N KNIK ST STE E",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547062",
"telephone_number": "907-308-0664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTLEY",
"first_name": "JEREMIAH",
"middle_name": "JAMES",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-05",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AK",
"license": "207404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.