Active NPI
Reva Jeanne Whitson, LMT
- Massage Therapist
- Myrtle Creek, OR
National Provider Identifier
1629542626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 22523
- Practice address
- 837 N Main St.
Myrtle Creek, OR 97457 - Phone
- (541) 863-4920
- NPI assigned
- Jan 14, 2019
- Last updated
- Jan 14, 2019
- Sex
- Female
- 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 | 22523 | OR | Primary |
Addresses
Primary practice location
837 N Main St.
Myrtle Creek, OR 97457
Mailing address
PO Box 185
Myrtle Creek, OR 97457-0019
Phone (541) 613-0669
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22523 | Other | OR | OBMT |
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 |
|---|---|---|---|
| 22523 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547424000000",
"number": "1629542626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 185",
"city": "MYRTLE CREEK",
"state": "OR",
"postal_code": "974570019",
"telephone_number": "541-613-0669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "837 N MAIN ST.",
"city": "MYRTLE CREEK",
"state": "OR",
"postal_code": "97457",
"telephone_number": "541-863-4920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITSON",
"first_name": "REVA",
"middle_name": "JEANNE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-14",
"last_updated": "2019-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "22523",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OBMT",
"identifier": "22523",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Creek, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.