NPIMap

Individual provider Active NPI

Jennifer Marie Bivens, L.M.T.

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1467772178
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7252 Issued in OR
Practice address
5331 SW Macadam Ave
Suite 105
Portland, OR 97239-6104
Phone
(503) 445-7999
Fax
(503) 445-7997
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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 7252 OR Primary

Addresses

Primary practice location

5331 SW Macadam Ave
Suite 105
Portland, OR 97239-6104

Mailing address

5331 SW Macadam Ave
Suite 105
Portland, OR 97239-6104
Phone (503) 445-7999

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
7252ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Element Wellness and Sports Rehabilitation Massage Therapist Past Accepting new patients
Eastside Wellness Center, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1467772178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 SW MACADAM AVE",
            "address_2": "SUITE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396104",
            "telephone_number": "503-445-7999",
            "fax_number": "503-445-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5331 SW MACADAM AVE",
            "address_2": "SUITE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396104",
            "telephone_number": "503-445-7999",
            "fax_number": "503-445-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVENS",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "7252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.