Active NPI
Daniel R Jiles, LMT
- Massage Therapist
- Bend, OR
National Provider Identifier
1790117190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 18470
- Practice address
- 1010 NW Harriman St
Bend, OR 97701-1912 - Phone
- (541) 383-8910
- NPI assigned
- Aug 7, 2013
- Sex
- Male
- 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 | 18470 | OR | Primary |
Addresses
Primary practice location
1010 NW Harriman St
Bend, OR 97701-1912
Mailing address
1316 NW Albany Ave
Bend, OR 97701-3161
Phone (541) 678-8882
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 |
|---|---|---|---|
| 18470 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1790117190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1316 NW ALBANY AVE",
"city": "BEND",
"state": "OR",
"postal_code": "977013161",
"telephone_number": "541-678-8882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 NW HARRIMAN ST",
"city": "BEND",
"state": "OR",
"postal_code": "977011912",
"telephone_number": "541-383-8910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JILES",
"first_name": "DANIEL",
"middle_name": "R",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-07",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "18470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.