Jacob Bradley Williams, LMT, MMT, NMT, CLT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501014520 Issued in MI

Practice address

700 3 Mile Rd NW
Grand Rapids, MI 49544-8220

Phone

(231) 510-8630

NPI assigned

Feb 6, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacobi Williams Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1497518955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 JOHNSTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072831",
            "telephone_number": "231-510-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 3 MILE RD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448220",
            "telephone_number": "231-510-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACOB",
        "middle_name": "BRADLEY",
        "credential": "LMT, MMT, NMT, CLT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501014520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOBI",
            "last_name": "WILLIAMS",
            "credential": "LMT, MMT, NMT, CLT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gabriel B Williams IV, M.D.
• Hailey E Williams, LMSW
• Haley Williams
• Hannah Elizabeth Hilliard Williams, MD
• Isabelle Grace Williams
• Jaime Williams
• Jaleesa Monee Williams, LMSW
• Jamel James Williams
• James Williams, CAA
• Janna Lynn Williams, MD

• Massage Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.