Jacob Gilbert, LMT

Key facts

NPI

1659914232

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

243355 (KY)

Practice address

1301 Herr LN
Graymoor Devondale, KY 40222-4388

Phone

(502) 412-9383

NPI assigned

Oct 25, 2019

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Meridian Lines, LLC Massage Therapist · Louisville, KY · NPI 1629392477
  NPD (past) MASSAGE THERAPIST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 25, 2019.

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1659914232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FORREST HILL DR",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400477504",
            "telephone_number": "502-724-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 HERR LN",
            "city": "GRAYMOOR DEVONDALE",
            "state": "KY",
            "postal_code": "402224388",
            "telephone_number": "502-412-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "JACOB",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "243355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}