Active NPI
Jamie Janine Weisse, LMT
- Massage Therapist
- Loves Park, IL
National Provider Identifier
1508150665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.001061
- Practice address
- 510 E Riverside Blvd
Loves Park, IL 61111-4632 - Phone
- (815) 877-1910
- NPI assigned
- Jun 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 227.001061 | IL | Primary |
Addresses
Primary practice location
510 E Riverside Blvd
Loves Park, IL 61111-4632
Mailing address
4251 Shorewood Dr
Rockford, IL 61101-9368
Phone (815) 980-0477
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 |
|---|---|---|---|
| 227.001061 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1508150665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4251 SHOREWOOD DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611019368",
"telephone_number": "815-980-0477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 E RIVERSIDE BLVD",
"city": "LOVES PARK",
"state": "IL",
"postal_code": "611114632",
"telephone_number": "815-877-1910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISSE",
"first_name": "JAMIE",
"middle_name": "JANINE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-07",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.001061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loves Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.