Individual provider Active NPI

Jacob Bernard Caldwell, LMP

  • Reflexologist
  • Seattle, WA
National Provider Identifier
1487811030
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ReflexologistTaxonomy code 173C00000X
License
MA00016444 Issued in WA
Practice address
609 10TH Ave E
Seattle, WA 98102-5019
Phone
(206) 571-4267
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reflexologist 173C00000X MA00016444 WA Primary

Addresses

Primary practice location

609 10TH Ave E
Seattle, WA 98102-5019

Mailing address

1318 N 167TH St
Shoreline, WA 98133-5408

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
MA00016444WAMDReflexologist

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1487811030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 N 167TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 10TH AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025019",
            "telephone_number": "206-571-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JACOB",
        "middle_name": "BERNARD",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "WA",
            "license": "MA00016444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.