Individual provider Active NPI

Jayson Vezzoso, M.T.

  • Massage Therapist
  • Carbondale, CO
National Provider Identifier
1639419294
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
5855 Issued in CO
Practice address
564 Highway 133
Carbondale, CO 81623-1645
Phone
(970) 963-2700
NPI assigned
Feb 19, 2013
Last updated
Feb 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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 5855 CO Primary

Addresses

Primary practice location

564 Highway 133
Carbondale, CO 81623-1645

Mailing address

111 Willow LN
Carbondale, CO 81623-9517
Phone (970) 948-7651

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
5855COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brownell Physical Therapy, LLC PastSince Mar 1, 2012 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1639419294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WILLOW LN",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816239517",
            "telephone_number": "970-948-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 HIGHWAY 133",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816231645",
            "telephone_number": "970-963-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEZZOSO",
        "first_name": "JAYSON",
        "credential": "M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "5855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.