Leandra Jackson, RMT

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

MT-002445 Issued in CO

Practice address

7967 Gladwater Rd
Peyton, CO 80831-6067

Phone

(719) 232-2653

NPI assigned

Jul 16, 2009

Last updated

Apr 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peak Spa and Wellness, LLC

  • Massage Therapist
  • Peyton, CO
  • NPI 1710343595
  NPD Authorized official

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1730319443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7967 GLADWATER RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808316067",
            "telephone_number": "719-232-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7967 GLADWATER RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808316067",
            "telephone_number": "719-232-2653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3938 JFK Pkwy Unit 11F",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805253087",
            "country_code": "US",
            "telephone_number": "970-204-0516",
            "fax_number": "970-204-0516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LEANDRA",
        "credential": "RMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "919508",
            "primary": false
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "CO",
            "license": "MT-002445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MASSAGE THERAPY",
            "identifier": "1710343595",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda J Huckstep, MPT
• Scott Gordon Hunter, PHARMD
• Kenneth Shane Hyman
• Inner Healing Counseling LLC
• Kelsie Lynn Ives, MBA, MS, RD
• Nancy A James, PT
• Joesph's Expertise, Inc
• John C. Haeseker, O.D. PC
• Caroline Johnson, LCSW
• Jay B Johnson, DMD

• Mechanotherapist in Peyton, CO
• Providers in Peyton, CO by specialty
• Mechanotherapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.