Active NPI
Aalexyz Mychelle Wilkinson, LMT
- Massage Therapist
- Medford, OR
National Provider Identifier
1689457780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27816
- 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, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 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
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 |
|---|---|---|---|
| 27816 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New 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.