Jack C Calvert, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60337092 Issued in WA

Practice address

155 N Ely St
Kennewick, WA 99336-2941

Phone

(509) 735-6479

NPI assigned

May 10, 2013

Last updated

May 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1780020222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 TIERRA VIDA LN",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015085",
            "telephone_number": "509-855-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N ELY ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362941",
            "telephone_number": "509-735-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVERT",
        "first_name": "JACK",
        "middle_name": "C",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60337092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.