Active NPI
Jonah Michael Glover, CMT
- Massage Therapist
- Shasta Lake, CA
National Provider Identifier
1568366151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 99920
- Practice address
- 4701 Main St
Shasta Lake, CA 96019-9765 - Phone
- (928) 297-8471
- NPI assigned
- Oct 6, 2026
- Last updated
- Oct 6, 2026
- Sex
- Male
- 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 | 99920 | CA | Primary |
Addresses
Primary practice location
4701 Main St
Shasta Lake, CA 96019-9765
Mailing address
4701 Main St
Shasta Lake, CA 96019-9765
Phone (928) 297-8471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791244800000",
"number": "1568366151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 MAIN ST",
"city": "SHASTA LAKE",
"state": "CA",
"postal_code": "960199765",
"telephone_number": "928-297-8471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 MAIN ST",
"city": "SHASTA LAKE",
"state": "CA",
"postal_code": "960199765",
"telephone_number": "928-297-8471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "JONAH",
"middle_name": "MICHAEL",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-10-06",
"last_updated": "2026-10-06",
"certification_date": "2026-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "99920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shasta Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.