Active NPI
Jason Matthew Kretzer, L.M.T.
- Massage Therapist
- Grants Pass, OR
National Provider Identifier
1861824971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 14557
- Practice address
- 2900 NW Vine St
Sutie B
Grants Pass, OR 97526-8411 - Phone
- (423) 331-0188
- NPI assigned
- Jul 31, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 14557 | OR | Primary |
Addresses
Primary practice location
2900 NW Vine St
Sutie B
Grants Pass, OR 97526-8411
Mailing address
469 Rancho Vista Dr
Grants Pass, OR 97526-3735
Phone (423) 331-0188
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 |
|---|---|---|---|
| 14557 | OR | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1861824971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "469 RANCHO VISTA DR",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975263735",
"telephone_number": "423-331-0188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 NW VINE ST",
"address_2": "SUTIE B",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975268411",
"telephone_number": "423-331-0188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRETZER",
"first_name": "JASON",
"middle_name": "MATTHEW",
"credential": "L.M.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-31",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "14557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.