Jeremy Arthur Minnick, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 25921 Issued in FL

Practice address

2143 NW 17TH Ave
Cape Coral, FL 33993-3101

Phone

(239) 671-9900

Fax

(239) 772-0146

NPI assigned

Sep 22, 2006

Last updated

Jul 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Coast to Coast Massage Therapy by Jeremy Minnick Inc.

  • Massage Therapist
  • Cape Coral, FL
  • NPI 1356696934
  NPD (past) Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1659471522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2143 NW 17TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339933101",
            "telephone_number": "239-671-9900",
            "fax_number": "239-772-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 NW 17TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339933101",
            "telephone_number": "239-671-9900",
            "fax_number": "239-772-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "JEREMY",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 25921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL.",
            "identifier": "C3738",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.