Individual provider Active NPI

Jamie Lynn Costello, RMT

  • Massage Therapist
  • Denver, CO
National Provider Identifier
1871840512
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
11048 Issued in CO
Practice address
4022 Tennyson St.
Denver, CO 80212-3935
Phone
(636) 297-5222
NPI assigned
Aug 13, 2012
Last updated
Sep 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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 11048 CO Primary

Addresses

Primary practice location

4022 Tennyson St.
Denver, CO 80212-3935

Mailing address

4022 Tennyson St.
Denver, CO 80212-3935
Phone (636) 297-5222

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
11048COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Community Wellness Past Accepting new patients

Organizations & group practices 1

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": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1871840512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 TENNYSON ST.",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802123935",
            "telephone_number": "636-297-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 TENNYSON ST.",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802123935",
            "telephone_number": "636-297-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "RMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "11048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.