Individual provider Active NPI

Jesse Taylor, LMT

  • Massage Therapist
  • Blue Island, IL
National Provider Identifier
1861853723
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227017843 Issued in IL
Practice address
13100 Greenwood Ave
Blue Island, IL 60406-2308
Phone
(847) 532-3111
NPI assigned
Mar 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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 227017843 IL Primary

Addresses

Primary practice location

13100 Greenwood Ave
Blue Island, IL 60406-2308

Mailing address

13100 Greenwood Ave
Blue Island, IL 60406-2308
Phone (847) 532-3111

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
227017843ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1861853723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13100 GREENWOOD AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062308",
            "telephone_number": "847-532-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 GREENWOOD AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062308",
            "telephone_number": "847-532-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227017843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.