Individual provider Active NPI

Barndon J Jackson, LMT

  • Massage Therapist
  • West Palm Beach, FL
National Provider Identifier
1720851348
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA76382 Issued in FL
Practice address
312 23Rd St
West Palm Beach, FL 33407-5913
Phone
(561) 351-8395
NPI assigned
Nov 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA76382 FL Primary

Addresses

Primary practice location

312 23Rd St
West Palm Beach, FL 33407-5913

Mailing address

312 23Rd St
West Palm Beach, FL 33407-5913

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
MA76382FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1720851348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 23RD ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334075913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 23RD ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334075913",
            "telephone_number": "561-351-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BARNDON",
        "middle_name": "J",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA76382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.