Individual provider Active NPI

Edwind Allen Holsey, MASSAGE THERAPIST

  • Massage Therapist
  • Jackson, MI
National Provider Identifier
1619407046
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
L664924 Issued in MI
Practice address
908 Union St
Jackson, MI 49203-2897
Phone
(517) 945-8117
Fax
(517) 945-8117
NPI assigned
Jun 18, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X L664924 MI Primary

Addresses

Primary practice location

908 Union St
Jackson, MI 49203-2897

Mailing address

908 Union St
Jackson, MI 49203-2897
Phone (517) 945-8117

Other practice location 1

300 Huron st
Ann Arbor, MI 48103
Phone (517) 945-8117

Other names 1

  • Mr. Allen Holsey Other name

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

LicenseStateTypeSpecialty
L664924MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619407046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 UNION ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492032897",
            "telephone_number": "517-945-8117",
            "fax_number": "517-945-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 UNION ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492032897",
            "telephone_number": "517-945-8117",
            "fax_number": "517-945-8117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Huron st",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48103",
            "country_code": "US",
            "telephone_number": "517-945-8117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLSEY",
        "first_name": "EDWIND",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "L664924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLEN",
            "last_name": "HOLSEY",
            "prefix": "MR.",
            "credential": "MASSAGE THERAPIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.