Active NPI
Stephen Jacoby
- Massage Therapist
- Mission, KS
National Provider Identifier
1578201745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2022013157
- Practice address
- 5400 Russell St
Mission, KS 66202-1662 - Phone
- (303) 525-7658
- NPI assigned
- May 26, 2022
- 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 | 2022013157 | MO | Primary |
Addresses
Primary practice location
5400 Russell St
Mission, KS 66202-1662
Mailing address
5400 Russell St
Mission, KS 66202-1662
Phone (303) 525-7658
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 |
|---|---|---|---|
| 2022013157 | MO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653523200000",
"number": "1578201745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 RUSSELL ST",
"city": "MISSION",
"state": "KS",
"postal_code": "662021662",
"telephone_number": "303-525-7658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 RUSSELL ST",
"city": "MISSION",
"state": "KS",
"postal_code": "662021662",
"telephone_number": "303-525-7658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBY",
"first_name": "STEPHEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-26",
"last_updated": "2022-05-26",
"certification_date": "2022-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MO",
"license": "2022013157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, KS
- Infinity Associates Inc
- Gregory V Ingram, DC
- Innerbridge Psychiatry & Therapy LLC
- Integrity Counseling Services
- Stephanie Iszory, LCMFT
- Melissa L Jensen, P.T.A.
- Robert E Jevons, MD
- Johnson County Department of Health and Enviornment
- Johnson County Mental Health Center
- Johnson County Mental Health Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.