The Educated Body, LLC

Primary specialty

MechanotherapistTaxonomy code 172M00000X

Legal business name

THE EDUCATED BODY, LLC

Practice address

3542 Franklin Ave
Miami, FL 33133-5716

Phone

(305) 396-1861

NPI assigned

Aug 24, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline Tibbett, PHD-LMT

Title

Manager

Phone

(305) 396-1681

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598227200000",
    "number": "1750994471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3542 FRANKLIN AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331335716",
            "telephone_number": "305-396-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3542 FRANKLIN AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331335716",
            "telephone_number": "305-396-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EDUCATED BODY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "TIBBETT",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-396-1681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD-LMT"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mechanotherapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://heal-match.com/business/jacqueline-tibbett-phd-lmt/",
            "affiliation": "N",
            "endpointDescription": "Business Directory Profile",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Messaging",
            "address_1": "3542 Franklin Ave",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331335716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.