Individual provider Active NPI

Jeremy Thomas Scotten, LMT

  • Massage Therapist
  • Tolleson, AZ
National Provider Identifier
1619704731
Registry record updated Sep 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-29795 Issued in AZ
Practice address
10021 W Williams St
Tolleson, AZ 85353-8327
Phone
(623) 695-1581
NPI assigned
Sep 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2024

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 MT-29795 AZ Primary

Addresses

Primary practice location

10021 W Williams St
Tolleson, AZ 85353-8327

Mailing address

10021 W Williams St
Tolleson, AZ 85353-8327
Phone (623) 695-1581

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
MT-29795AZMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1726272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726272000000",
    "number": "1619704731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 W WILLIAMS ST",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538327",
            "telephone_number": "623-695-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 W WILLIAMS ST",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538327",
            "telephone_number": "623-695-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTTEN",
        "first_name": "JEREMY",
        "middle_name": "THOMAS",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-14",
        "last_updated": "2024-09-14",
        "certification_date": "2024-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-29795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolleson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2024; 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.