Individual provider Active NPI

Jill Ann Gillan-Vavreck, LMT

  • Massage Therapist
  • Amherst, NY
National Provider Identifier
1821431313
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
026894-1 Issued in NY
Practice address
1416 Sweet Home Rd
Suite 7
Amherst, NY 14228-2784
Phone
(716) 450-7023
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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 026894-1 NY Primary

Addresses

Primary practice location

1416 Sweet Home Rd
Suite 7
Amherst, NY 14228-2784

Mailing address

1416 Sweet Home Rd
Suite 7
Amherst, NY 14228-2784
Phone (716) 450-7023

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

LicenseStateTypeSpecialty
026894-1NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1821431313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 SWEET HOME RD",
            "address_2": "SUITE 7",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282784",
            "telephone_number": "716-450-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 SWEET HOME RD",
            "address_2": "SUITE 7",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282784",
            "telephone_number": "716-450-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLAN-VAVRECK",
        "first_name": "JILL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "026894-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.