Individual provider Active NPI

Aalexyz Mychelle Wilkinson, LMT

  • Massage Therapist
  • Medford, OR
National Provider Identifier
1689457780
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27816 Issued in OR
Practice address
940 Town Centre Dr Ste B
Medford, OR 97504-6165
Phone
(458) 658-4286
NPI assigned
Aug 14, 2023
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 27816 OR Primary

Addresses

Primary practice location

940 Town Centre Dr Ste B
Medford, OR 97504-6165

Mailing address

1106 W 10TH St
Medford, OR 97501-3022
Phone (458) 658-4286

Other practice location 1

1106 W 10th St
Medford, OR 97501-3022
Phone (458) 658-4286

Other practice location 2

3143 Signature Ct
Medford, OR 97504-7738
Phone (541) 200-2444

Other practice location 3

645 N 5th St
Jacksonville, OR 97530-9659
Phone (541) 899-2760

Other names 1

  • Kaeci Mychelle Wilkinson Other name

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

LicenseStateTypeSpecialty
27816ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Chiropractic Clinic LLC Single Specialty 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.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1689457780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 W 10TH ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013022",
            "telephone_number": "458-658-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 TOWN CENTRE DR STE B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046165",
            "telephone_number": "458-658-4286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1106 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975013022",
            "country_code": "US",
            "telephone_number": "458-658-4286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3143 Signature Ct",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975047738",
            "country_code": "US",
            "telephone_number": "541-200-2444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "645 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "OR",
            "postal_code": "975309659",
            "country_code": "US",
            "telephone_number": "541-899-2760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "AALEXYZ",
        "middle_name": "MYCHELLE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAECI",
            "last_name": "WILKINSON",
            "middle_name": "MYCHELLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.