Active NPI
Jerry Lee Brand, LMT
- Massage Therapist
- Gahanna, OH
National Provider Identifier
1861759656
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 33-020021
- Practice address
- 618 Ridenour Rd
Gahanna, OH 43230-2067 - Phone
- (614) 207-7578
- NPI assigned
- Apr 18, 2012
- 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 | 33-020021 | OH | Primary |
Addresses
Primary practice location
618 Ridenour Rd
Gahanna, OH 43230-2067
Mailing address
618 Ridenour Rd
Gahanna, OH 43230-2067
Phone (614) 207-7578
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33-020021 | OH | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356307200000",
"number": "1861759656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 RIDENOUR RD",
"city": "GAHANNA",
"state": "OH",
"postal_code": "432302067",
"telephone_number": "614-207-7578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 RIDENOUR RD",
"city": "GAHANNA",
"state": "OH",
"postal_code": "432302067",
"telephone_number": "614-207-7578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAND",
"first_name": "JERRY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-18",
"last_updated": "2012-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OH",
"license": "33-020021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gahanna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.