Active NPI
Jennifer Kristen Carruba, LCMT
- Massage Therapist
- Coventry, RI
National Provider Identifier
1649834805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT01547
- Practice address
- 2260 Flat River Rd Unit 9
Coventry, RI 02816-8959 - Phone
- (401) 385-9485
- Fax
- (401) 385-9485
- NPI assigned
- Apr 23, 2019
- Last updated
- Apr 23, 2019
- Sex
- Female
- Sole proprietor
- No
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 | MT01547 | RI | Primary |
Addresses
Primary practice location
2260 Flat River Rd Unit 9
Coventry, RI 02816-8959
Mailing address
37 Glendale Ave
Warwick, RI 02889-1513
Phone (401) 241-4228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MT01547 | Other | RI | RI MASSAGE LICENSE |
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 |
|---|---|---|---|
| MT01547 | RI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555977600000",
"number": "1649834805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 GLENDALE AVE",
"city": "WARWICK",
"state": "RI",
"postal_code": "028891513",
"telephone_number": "401-241-4228",
"fax_number": "401-385-9485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2260 FLAT RIVER RD UNIT 9",
"city": "COVENTRY",
"state": "RI",
"postal_code": "028168959",
"telephone_number": "401-385-9485",
"fax_number": "401-385-9485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRUBA",
"first_name": "JENNIFER",
"middle_name": "KRISTEN",
"credential": "LCMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-23",
"last_updated": "2019-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "RI",
"license": "MT01547",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI MASSAGE LICENSE",
"identifier": "MT01547",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coventry, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.