Active NPI
Sonni Lee Jackson, LMT
- Massage Therapist
- New Castle, CO
National Provider Identifier
1811466469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT.0011121
- Practice address
- 151 E Clubhouse Dr
New Castle, CO 81647-9424 - Phone
- (970) 618-7537
- NPI assigned
- Nov 13, 2018
- Last updated
- Nov 13, 2018
- 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 | MT.0011121 | CO | Primary |
Addresses
Primary practice location
151 E Clubhouse Dr
New Castle, CO 81647-9424
Mailing address
171 Ute Way
Silt, CO 81652-9580
Phone (970) 618-7537
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 |
|---|---|---|---|
| MT.0011121 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1811466469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 UTE WAY",
"city": "SILT",
"state": "CO",
"postal_code": "816529580",
"telephone_number": "970-618-7537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 E CLUBHOUSE DR",
"city": "NEW CASTLE",
"state": "CO",
"postal_code": "816479424",
"telephone_number": "970-618-7537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SONNI",
"middle_name": "LEE",
"name_prefix": "Miss",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-13",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT.0011121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Castle, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.