Jessica Jean Kidder

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

021752-1 Issued in NY

Practice address

7383 Utica Blvd
Lowville, NY 13367-9503

Phone

(315) 376-2256

NPI assigned

Sep 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Open Sky Wellness, LLC

  • Massage Therapist
  • Lowville, NY
  • NPI 1700308210
  NPD
• Open Sky Healing Arts Center LLC

  • Physical Therapist
  • Lowville, NY
  • NPI 1356670368

  Massage Therapist

  NPD (past)

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1639720634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7383 UTICA BLVD",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133679503",
            "telephone_number": "315-376-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7383 UTICA BLVD",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133679503",
            "telephone_number": "315-376-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "JESSICA",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "021752-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lynn Kelly, R.N.
• Maryam Bethany Kelly, PA-C
• Rebecca Plemons Kelly
• Sierra Kempney
• William Francis Kenny, M.D., FAPA
• Nicole Lyn Kilburn, OTR
• Matthew Kirkwood
• Gifferd Ko, DPM, MSC
• Sandeep S Kochar, MD
• John Kozick

• Massage Therapist in Lowville, NY
• Providers in Lowville, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.