Active NPI
Jeremiah W Cook, LMT
- Massage Therapist
- Carlton, OR
National Provider Identifier
1568587194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13614
- Practice address
- 310 S 3Rd St
Carlton, OR 97111-0610 - Phone
- (503) 939-2946
- NPI assigned
- Mar 20, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 13614 | OR | Primary |
| Massage Therapist | 225700000X | MA00023290 | WA |
Addresses
Primary practice location
310 S 3Rd St
Carlton, OR 97111-0610
Mailing address
PO Box 610
Carlton, OR 97111-0610
Phone (503) 939-2946
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 |
|---|---|---|---|
| 13614 | OR | MD | Pharmacist |
| MA00023290 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Path Massage Inc | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568587194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 610",
"city": "CARLTON",
"state": "OR",
"postal_code": "971110610",
"telephone_number": "503-939-2946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 S 3RD ST",
"city": "CARLTON",
"state": "OR",
"postal_code": "971110610",
"telephone_number": "503-939-2946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "JEREMIAH",
"middle_name": "W",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "13614",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00023290",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.