Jennifer Dawn Long, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501008361 Issued in MI

Practice address

620 N State St
Stanton, MI 48888-8749

Phone

(616) 821-5266

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1730733460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 E KLEES RD",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N STATE ST",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488888749",
            "telephone_number": "616-821-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501008361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jengemski@gmail.com",
            "affiliation": "N",
            "address_1": "620 N State St",
            "city": "Stanton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488888749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephen Fredrick Lindeman, MA, LLPC
• Cerissa Elizabeth Lingeman, RN
• Krista Lockner
• Angela Loiselle
• Candace Long
• Nieves Lopez
• Lori K Crossman, LMSW, LLC
• McKenzie Faith Lott
• David E Lyon, DO
• Melissa Maclaren

• Massage Therapist in Stanton, MI
• Providers in Stanton, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.