Active NPI
Penelope L Winks, LMT
- Massage Therapist
- Bloomington, IL
National Provider Identifier
1720850159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.023255
- Practice address
- 2415 E Washington St Ste F
Bloomington, IL 61704-1609 - Phone
- (309) 706-7040
- NPI assigned
- Oct 30, 2023
- 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 | 227.023255 | IL | Primary |
Addresses
Primary practice location
2415 E Washington St Ste F
Bloomington, IL 61704-1609
Mailing address
25871 N 1475 East Rd
Hudson, IL 61748-9378
Phone (309) 706-7040
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 |
|---|---|---|---|
| 227.023255 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1720850159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25871 N 1475 EAST RD",
"city": "HUDSON",
"state": "IL",
"postal_code": "617489378",
"telephone_number": "309-706-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 E WASHINGTON ST STE F",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617041609",
"telephone_number": "309-706-7040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINKS",
"first_name": "PENELOPE",
"middle_name": "L",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-30",
"last_updated": "2023-10-30",
"certification_date": "2023-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.023255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.