Active NPI
Jaime L Collick, MASSAGE THERAPIST
- Massage Therapist
- Avoca, MI
National Provider Identifier
1780241257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7501007480
- Practice address
- 5521 Cherry St
Avoca, MI 48006 - Phone
- (810) 300-4178
- NPI assigned
- May 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7501007480 | MI | Primary |
Addresses
Primary practice location
5521 Cherry St
Avoca, MI 48006
Mailing address
PO Box 305
Avoca, MI 48006-0305
Phone (810) 300-4178
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7501007480 | MI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558396800000",
"number": "1780241257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 305",
"city": "AVOCA",
"state": "MI",
"postal_code": "480060305",
"telephone_number": "810-300-4178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5521 CHERRY ST",
"city": "AVOCA",
"state": "MI",
"postal_code": "48006",
"telephone_number": "810-300-4178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLICK",
"first_name": "JAIME",
"middle_name": "L",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-21",
"last_updated": "2019-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "MI",
"license": "7501007480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avoca, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.