NPIMap

Individual provider Active NPI

Jennifer Derecola, LMT

  • Massage Therapist
  • Fleetwood, PA
National Provider Identifier
1821388042
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
14128 Kutztown Rd.
Fleetwood, PA 19522
Phone
(610) 944-9647
NPI assigned
Apr 8, 2011
Last updated
Apr 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Primary

Addresses

Primary practice location

14128 Kutztown Rd.
Fleetwood, PA 19522

Mailing address

6 Hearthstone CT.
200
Reading, PA 19606
Phone (610) 685-1761

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fleetwood Chiropractic & Wellness Center, PC Past Accepting new patients
Gregory a. Jones DC PC Past Accepting new patients
Elements to Wellness, LLC Massage Therapist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1821388042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HEARTHSTONE CT.",
            "address_2": "200",
            "city": "READING",
            "state": "PA",
            "postal_code": "19606",
            "telephone_number": "610-685-1761",
            "fax_number": "610-779-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14128 KUTZTOWN RD.",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "19522",
            "telephone_number": "610-944-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERECOLA",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleetwood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.