Active NPI
Jayson Vezzoso, M.T.
- Massage Therapist
- Carbondale, CO
National Provider Identifier
1639419294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 5855
- Practice address
- 564 Highway 133
Carbondale, CO 81623-1645 - Phone
- (970) 963-2700
- NPI assigned
- Feb 19, 2013
- Last updated
- Feb 19, 2013
- 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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5855 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brownell Physical Therapy, LLC | Past | 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.
-
- Physical Therapy Clinic/Center
- Carbondale, CO
- NPI 1902179120
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.