Individual provider Active NPI

Jackie L Goree, MEDICAL MASSAGE THER

  • Massage Therapist
  • Elk Grove, CA
National Provider Identifier
1457478240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
620879 Issued in CA
Practice address
8437 Elk Grove Florin Rd
Elk Grove, CA 95624-9518
Phone
(916) 689-6726
NPI assigned
Mar 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 620879 CA Primary

Addresses

Primary practice location

8437 Elk Grove Florin Rd
Elk Grove, CA 95624-9518

Mailing address

9270 Tamerton Way
Sacramento, CA 95829-9237
Phone (916) 689-6726

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
620879CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457478240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9270 TAMERTON WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958299237",
            "telephone_number": "916-689-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8437 ELK GROVE FLORIN RD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956249518",
            "telephone_number": "916-689-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOREE",
        "first_name": "JACKIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MEDICAL MASSAGE THER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "620879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.