Active NPI
Melinda Salem-Jackson, NCTMB, LMT, CMMT
- Massage Therapist
- Ben Wheeler, TX
National Provider Identifier
1700113446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT-08893
- Practice address
- 2695 Van Zandt CR 4923
Ben Wheeler, TX 75754-4440 - Phone
- (903) 368-4200
- NPI assigned
- Nov 17, 2009
- Last updated
- Oct 2, 2013
- 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 | MT-08893 | AZ | Primary |
Addresses
Primary practice location
2695 Van Zandt CR 4923
Ben Wheeler, TX 75754-4440
Mailing address
2695 VZ County Road 4923
Ben Wheeler, TX 75754-4440
Phone (903) 368-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MT-116546 | Other | TX | STATE 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 |
|---|---|---|---|
| MT-08893 | AZ | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380672000000",
"number": "1700113446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2695 VZ COUNTY ROAD 4923",
"city": "BEN WHEELER",
"state": "TX",
"postal_code": "757544440",
"telephone_number": "903-368-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2695 VAN ZANDT CR 4923",
"city": "BEN WHEELER",
"state": "TX",
"postal_code": "757544440",
"telephone_number": "903-368-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALEM-JACKSON",
"first_name": "MELINDA",
"credential": "NCTMB, LMT, CMMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-17",
"last_updated": "2013-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AZ",
"license": "MT-08893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "MT-116546",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ben Wheeler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.