Jeana Corleen Anderson, MMT, CLT, CNHP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

8302 Issued in AR

Practice address

2621 W Main St Ste 9
Russellville, AR 72801-2551

Phone

(501) 690-3306

NPI assigned

Oct 20, 2020

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 20, 2020.

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1881293975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CHRISTMAS DR",
            "city": "CASA",
            "state": "AR",
            "postal_code": "720257514",
            "telephone_number": "501-233-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 W MAIN ST STE 9",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012551",
            "telephone_number": "501-690-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JEANA",
        "middle_name": "CORLEEN",
        "credential": "MMT, CLT, CNHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AR",
            "license": "8302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amedco Arkansas PLLC
• American Oncology Partners, P.a.
• Ashton Nicole Amos, ST
• Amy J S Daiber OD PA
• Casey Anderson, RECOVERY ASSISTANT
• Randall Alan Anderson, LPE-I
• Edward L Andrada, MD
• Katherine Angel
• Ana Isabel Angeles Arredondo, RBT
• Anne Keenan LCSW and Associates

• All providers in Russellville, AR
• Massage Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.